LEFT-VENTRICULAR SYSTOLIC TORSION AND EARLY DIASTOLIC FILLING BY ECHOCARDIOGRAPHY IN NORMAL HUMANS

This study describes a novel 2-dimensional echocardiographic technique to measure left ventricular (LV) systolic twist in humans and relates this measure to early ventricular filling. LV twist is the counterclo ckwise rotation of the left ventricle during systole when viewed from the apex, The effect of ventricular twist has been postulated to store potential energy, which ultimately aids in diastolic recoil, leading to ventricular suction, The generated negative early diastolic pressur es may augment early ventricular filling. We measured ventricular twis t in 40 patients with normal transthoracic echocardiograms. End-systol ic twist was determined by measuring rotation of the anterolateral pap illary muscle about the center of the ventricle, LV filling was assess ed by analysis of transmitral Doppler flow velocities. The mean value obtained was 9 +/- 7 degrees of rotation, Twist measurements were high ly reproducible with an intraobserver correlation coefficient of r = 0 .881, p <0.001. The magnitude of ventricular twist was strongly correl ated positively with acceleration of the mitral E-wave (r = 0.75; p <0 .0001) and negatively with the mitral E-wave acceleration time (r = -0 .83; p <0.0001). (C) 1998 by Excerpta Medica, Inc.