Introduction: Left ventricular(LV) torsion has been proposed as a sensitive index for LV function. Our goal was to assess the preload-dependency of LV torsion in patients undergoing hemodialysis.
Method: 25 patients with end stage renal disease underwent echocardiogrphy before and immediately after hemodialysis. To assess LV torsion, LV rotation were acquired at apical, mid and basal levels with speckle tracking software. Apical-LV torsion was defined as the net deference of LV rotation between the apical and basal planes. Mid-LV torsion was defined between the mid papillary muscle level and basal planes. Diastolic untwist was estimated by diastolic torsional deformation slope during the early relaxation period. Systolic torsional dynamics were assessed by minimal torsion(Tmin;peak negative clockwise torsion in early systole) and maximal torsion(Tmax).
Result: Data on 20 of 25 patients were usable for analysis. After hemodialysis(3.1짹0.9L), the early diastolic untwist was not changed(MID:-0.32째vs -0.29째/ms, AP:-0.47째vs -0.56째/ms). Systoloic Tmax was not changed(MID:9.08째vs 9.67째, AP: 16.82째vs 17.80째). Interestingly, during early systole, Tmin was significantly decreased(MID:-0.3짹0.3째vs -0.7짹0.7째;p<0.05, AP:-0.6짹0.7 vs -1.1짹1.1째;p<0.05).
Conclusion: Early diastolic untwist may be a preload independent parameter of LV diastolic dysfunction. Early systolic LV torsional deformation is thought to be sensitive to preload change. Such parameters may be valuable tools for evaluation of LV diastolic and systolic function.