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Evaluation of left ventricular torsion in children with hypertrophic cardiomyopathy

Published online by Cambridge University Press:  07 February 2013

Christian Prinz ,
Lothar Faber ,
Dieter Horstkotte ,
Hermann Körperich ,
Axel Moysich ,
Nikolaus Haas ,
Deniz Kececioglu  and
Kai Thorsten Laser
Christian Prinz*
Affiliation:
Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Lothar Faber
Affiliation:
Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Dieter Horstkotte
Affiliation:
Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Hermann Körperich
Affiliation:
Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Axel Moysich
Affiliation:
Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Nikolaus Haas
Affiliation:
Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Deniz Kececioglu
Affiliation:
Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
Kai Thorsten Laser
Affiliation:
Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
*
Correspondence to: Dr C. Prinz, MD, Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany. Tel: +49-151-15564942; Fax: +49-573197-2194; E-mail: Cchrprinz@aol.com
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Abstract

Aims

To evaluate the role of torsion in hypertrophic cardiomyopathy in children.

Methods

A total of 88 children with idiopathic hypertrophic cardiomyopathy (n = 24) and concentric hypertrophy (n = 20) were investigated with speckle-tracking echocardiography and compared with age- and gender-matched healthy controls (n = 44).

Results

In hypertrophic cardiomyopathy, we found increased torsion (2.8 ± 1.6 versus 1.9 ± 1.0°/cm [controls], p < 0.05) because of an increase in clockwise basal rotation (−8.7 ± 4.3° versus −4.9 ± 2.5° [controls], p < 0.001) and prolonged time to peak diastolic untwisting (3.7 ± 2.4% versus 1.7 ± 0.6% [controls] of cardiac cycle, p < 0.01), but no differences in peak untwisting velocities. Hypertrophic cardiomyopathy patients demonstrated a negative correlation between left ventricular muscle mass and torsion (r = −0.7, p < 0.001). In concentric hypertrophy, torsion was elevated because of increased apical rotation (15.1 ± 6.4° versus 10.5 ± 5.5° [controls], p < 0.05) without correlation with muscle mass. Peak untwisting velocities (− 202 ± 88 versus −145 ± 67°/s [controls], p < 0.05) were higher in concentric hypertrophy and time to peak diastolic untwisting was delayed (1.8 ± 0.8% versus 1.2 ± 0.6% [controls], p < 0.05).

Conclusions

In contrast to an increased counterclockwise apical rotation in concentric hypertrophy, hypertrophic cardiomyopathy is characterised by predominantly enhanced systolic basal clockwise rotation. Diastolic untwisting is delayed in both groups. Torsion may be an interesting marker to guide patients with hypertrophic cardiomyopathy.

Keywords

Hypertrophic cardiomyopathyspeckle-tracking echocardiographytwisttorsionuntwisting
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 2 , April 2014 , pp. 245 - 252
Copyright
Copyright © Cambridge University Press 2013 

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