Left ventricular rotational mechanics in patients with coronary artery disease: differences in subendocardial and subepicardial layers

Bertini, Matteo, Delgado, Victoria, Nucifora, Gaetano, Marsan, Nina Ajmone, Ng, Arnold C. T., Shanks, Miriam, Antoni, M. Louisa, van de Veire, Nico R. L., van Bommel, Rutger J., Rapezzi, Claudio, Schalij, Martin J. and Bax, Jeroen J. (2010) Left ventricular rotational mechanics in patients with coronary artery disease: differences in subendocardial and subepicardial layers. Heart, 96 21: 1737-1743. doi:10.1136/hrt.2010.197533


Author Bertini, Matteo
Delgado, Victoria
Nucifora, Gaetano
Marsan, Nina Ajmone
Ng, Arnold C. T.
Shanks, Miriam
Antoni, M. Louisa
van de Veire, Nico R. L.
van Bommel, Rutger J.
Rapezzi, Claudio
Schalij, Martin J.
Bax, Jeroen J.
Title Left ventricular rotational mechanics in patients with coronary artery disease: differences in subendocardial and subepicardial layers
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
1468-201X
Publication date 2010-11
Sub-type Article (original research)
DOI 10.1136/hrt.2010.197533
Volume 96
Issue 21
Start page 1737
End page 1743
Total pages 7
Place of publication London, United Kingdom
Publisher BMJ Group
Language eng
Formatted abstract
Objective Subendocardial and subepicardial layers have opposite orientation of the myofibres and they are differently affected by coronary artery disease. This study investigated the differences in subendocardial and subepicardial left ventricular (LV) twist in patients with coronary artery disease.
Methods 214 patients were included in the study: 60 with first ST elevation myocardial infarction (STEMI), 111 with chronic ischaemic heart failure (HF) and 43 normal subjects. Real-time three-dimensional echocardiography provided LV volumes and function. Two-dimensional speckle tracking echocardiography differentiating the subendocardial and subepicardial layers was used for the assessment of LV twist. Patients with STEMI were divided into two groups (small and large STEMI).
Results Compared with normal subjects, peak subendocardial LV twist was significantly impaired in patients with STEMI (11.2±6.0° vs 15.3±2.7°, p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more impaired (4.6±3.4°, p<0.001 vs normal subjects and patients with STEMI). Conversely, peak subepicardial LV twist was not statistically different between normal subjects and patients with STEMI (8.9±1.9° vs 8.4±4.4°, p=0.98), whereas it was significantly impaired in patients with chronic HF (2.6±2.5°, p<0.001 vs normal subjects and patients with STEMI). Peak subendocardial LV twist was not statistically different between large and small STEMI, whereas peak subepicardial LV twist was significantly lower in large STEMI than in small STEMI (7.1±4.8° vs 9.6±3.6°, p=0.025).
Conclusions Subendocardial LV twist is reduced in patients with STEMI and chronic ischaemic HF whereas subepicardial LV twist is reduced only in chronic ischaemic HF. When STEMI are divided into large and small infarctions, it becomes evident that subepicardial LV twist is only reduced in large infarctions.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Medicine Publications
Centre for Advanced Imaging Publications
 
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Created: Sun, 14 Apr 2013, 23:58:39 EST by Dr Chin Tse Arnold Ng on behalf of Centre for Advanced Imaging