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The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function

Received: 31 December 2020     Accepted: 1 April 2021     Published: 23 November 2021
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Abstract

Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 7, Issue 6)
DOI 10.11648/j.ijcts.20210706.12
Page(s) 64-69
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Apical Rotations, Ejection Fraction, Myocardial Infarction, Speckle-Tracking Echocardiography, Torsion

References
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  • APA Style

    Mohamed Roshdy, Ramy Omar. (2021). The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. International Journal of Cardiovascular and Thoracic Surgery, 7(6), 64-69. https://doi.org/10.11648/j.ijcts.20210706.12

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    ACS Style

    Mohamed Roshdy; Ramy Omar. The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. Int. J. Cardiovasc. Thorac. Surg. 2021, 7(6), 64-69. doi: 10.11648/j.ijcts.20210706.12

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    AMA Style

    Mohamed Roshdy, Ramy Omar. The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function. Int J Cardiovasc Thorac Surg. 2021;7(6):64-69. doi: 10.11648/j.ijcts.20210706.12

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  • @article{10.11648/j.ijcts.20210706.12,
      author = {Mohamed Roshdy and Ramy Omar},
      title = {The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {7},
      number = {6},
      pages = {64-69},
      doi = {10.11648/j.ijcts.20210706.12},
      url = {https://doi.org/10.11648/j.ijcts.20210706.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20210706.12},
      abstract = {Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - The Mechanics of Apical Rotation in Patients with Myocardial Infarction and Reduced Left Ventricular Function
    AU  - Mohamed Roshdy
    AU  - Ramy Omar
    Y1  - 2021/11/23
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijcts.20210706.12
    DO  - 10.11648/j.ijcts.20210706.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
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    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20210706.12
    AB  - Background: Traditionally the use of Left ventricular ejection fraction (LVEF) for assessment of left ventricular (LV) systolic. Function is the most widely used method. However, this method is inaccurate after acute MI, this attributed to the development of wall-motion abnormalities after acute MI; Inaddition, the biplane Simpson method calculation is inaccurate, because it relys on geometric assumptions. Recently, the use of two-dimensional speckle-tracking imaging has facilitated noninvasive measurement of LV torsion. Objective: The aim of this study was to use speckle-tracking echocardiography to assess apical rotation in patients with anterior and inferior myocardial infarction (MI). Patients and methods: The present study enrolled 54 patients with anterior or inferior MI, in addition to 20 healthy volunteers (matched for age and sex) as the control group. Using commercially available two-dimensional strain software, apical, basal rotation, and LV torsion were calculated. Basal and apical LV short-axis images were acquired for further off-line analysis. Results: Apical rotation was significantly reduced in the patient group compared with the control group (P<0.001). Consequently, torsion degree (P<0.001), torsion rate, and untwisting rate (P=0.007) were significantly reduced. There was a significant correlation between ejection fraction and apex rotation (r=0.466, P=0.044), torsion degree (r=0.499, P=0.03), and untwisting rate (r=−0.543, P<0.001). Correlation with basal rotation was nonsignificant, and thus measurement of apical rotation alone (rather than calculation of LV torsion) might provide a simple and accurate alternative for assessment of LV contractility. Conclusion: Apical rotation and torsion were decreased in ST-elevation MI, and this was statistically significant in patients with LV dysfunction.
    VL  - 7
    IS  - 6
    ER  - 

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Author Information
  • Department of Cardiology, National Heart Institute, Cairo, Egypt

  • Department of Cardiology, National Heart Institute, Cairo, Egypt

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