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ȣ - 490165 120 |
| Does the Change of Left Ventricular Torsion After Dynamic Exercise Assessed by Novel Two-Dimensional Speckle Tracking Imaging Contribute to Increase Diastolic Suction? |
| 가천의과대학교 길병원 심장센터 심장내과 |
| 정욱진, 신미승, 오규진, 최경림, 김경순, 이상진, 고광곤, 안태훈, 최인석, 신익균 |
Background: Left ventricular (LV) torsion was believed to store potential energy and to play an important role in generating diastolic suction. And a newly developed two-dimensional speckle tracking imaging (STI) provide a more objective estimation of LV torsion. However there was no report about comparison of LV torsion assessed by this novel method with LV diastolic functional parameters after exercise. Methods: The study group included 112 participants (56 men and 56 women, mean age 40.5±1.1 years, range 15 to 66 years) with normal resting LV function and no detectable structural heart disease confirmed by echocardiography and exercise treadmill test. Two-dimensional echocardiographic examinations were performed at rest and immediately after exercise treadmill test. Postexercise image acqusition was completed within 3 minutes. 3 cardiac cycles from each baseline and postexercise recording were digitized and analyzed. LV torsion was measured by STI at papillary muscle level of LV. Results: Participants showed normal LV systolic functions (EF=65.4±0.4%) and normal left atrial volume index (21.9±0.6cc/m2). Participants exercised for an average of 10 min 47 sec±7 sec and achieved 94.6 ± 0.8% of maximally predicted for age with a mean peak heart rate 170±2 bpm. After exercise, LV torsion increased 23%, from 4.3±0.1 to 5.2±0.2 degrees(p=0.000). Also the duration difference between pulmonary venous atrial flow reversal and transmitral A wave, LV end diastolic volume, transmitral E/A ratio and deceleration time of transmitral E wave decreased (p=0.000, p=0.000, p=0.000 and p=0.001, respectively). And as we expected, the change of LV torsion showed significant correlations with the change of transmitral E/A ratio (r=-0.356 and p=0.000). For assessing LV torsion at resting and after exercise, the correlation coefficient was r=0.92. Conclusions: Increased LV torsion after exercise contributes to improve diastolic function. And two-dimensional STI may be a promising new method in assessing LV torsion after exercise as well as at resting.
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