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Review
. 2015 Aug 26;7(8):476-82.
doi: 10.4330/wjc.v7.i8.476.

Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices

Floris Kauer  1 , Marcel Leonard Geleijnse  1 , Bastiaan Martijn van Dalen  1
Affiliations
Review

Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices

Floris Kauer et al. World J Cardiol. .

Abstract

Left ventricular twist is an essential part of left ventricular function. Nevertheless, knowledge is limited in "the cardiology community" as it comes to twist mechanics. Fortunately the development of speckle tracking echocardiography, allowing accurate, reproducible and rapid bedside assessment of left ventricular twist, has boosted the interest in this important mechanical aspect of left ventricular deformation. Although the fundamental physiological role of left ventricular twist is undisputable, the clinical relevance of assessment of left ventricular twist in cardiomyopathies still needs to be established. The fact remains; analysis of left ventricular twist mechanics has already provided substantial pathophysiological understanding on a comprehensive variety of cardiomyopathies. It has become clear that increased left ventricular twist in for example hypertrophic cardiomyopathy may be an early sign of subendocardial (microvascular) dysfunction. Furthermore, decreased left ventricular twist may be caused by left ventricular dilatation or an extensive myocardial scar. Finally, the detection of left ventricular rigid body rotation in noncompaction cardiomyopathy may provide an indispensible method to objectively confirm this difficult diagnosis. All this endorses the value of left ventricular twist in the field of cardiomyopathies and may further encourage the implementation of left ventricular twist parameters in the "diagnostic toolbox" for cardiomyopathies.

Keywords: Cardiomyopathy; Left ventricular mechanics; Left ventricular twist.

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Figures

Figure 1
Figure 1
Example of QLAB workstation speckle-tracking analysis. Upper panel: 2D echo image of the basal left ventricular short axis. The software fully automatically draws the epicardial and endocardial contour of the myocardium. Lower panel: The software calculates the change in angle between the left ventricular (LV) wall and the virtual LV center during the cardiac cycle (green line). The blue and yellow line represent the angulation of the epicardial en endocardial angulation, respectively.
Figure 2
Figure 2
Overview of cardiomyopathies with corresponding abnormalities in left ventricular twist mechanics.
See this image and copyright information in PMC

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