Skip to main content
SpringerLink
Log in

Left ventricular twist during dobutamine stress echocardiography after acute myocardial infarction: association with reverse remodeling

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Left ventricular (LV) twist is emerging as a marker of global LV contractility after acute myocardial infarction (AMI). This study aimed to describe stress-induced changes in LV twist during dobutamine stress echocardiography (DSE) after AMI and investigate their association with LV reverse remodeling at 6 months follow-up. In 82 consecutive first AMI patients (61 ± 12 years, 85 % male) treated with primary percutaneous coronary intervention, DSE was performed at 3 months follow-up. Two-dimensional speckle-tracking-derived apical and basal rotation and LV twist were calculated at rest, low- and peak-dose stages. LV reverse remodeling was defined as ≥10 % decrease in LV end-systolic volume between baseline and 6 months follow-up. Patterns of LV twist response on DSE consisted of either a progressive increase throughout each stage (n = 18), an increase at either low- or peak-dose (n = 53) or no significant increase (n = 11). LV reverse remodeling occurred in 28 (34 %) patients, who showed significantly higher peak-dose LV twist (8.51° vs. 6.69°, p = 0.03) and more frequently progressive LV twist increase from rest to peak-dose (39 vs. 13 %, p < 0.01) compared to patients without reverse remodeling. Furthermore, increase in LV twist from rest to peak-dose was the only independent predictor of LV reverse remodeling at 6 months follow-up (OR 1.3, 95 % CI 1.1−1.5, p = 0.005). Both the pattern of progressive increase in LV twist and the stress-induced increment in LV twist on DSE are significantly associated with LV reverse remodeling at 6 month follow-up after AMI, suggesting its potential use as a novel marker of contractile reserve.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Blessberger H, Binder T (2010) Two dimensional speckle tracking echocardiography: clinical applications. Heart 96(24):2032–2040

    Article  PubMed  Google Scholar 

  2. Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin-Miklovic MG, Weaver JA, Oryszak SJ, Greenberg NL, White RD, Thomas JD (2005) Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 45(12):2034–2041

    Article  PubMed  Google Scholar 

  3. Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, Rosen BD, Lima JA, Torp H, Ihlen H, Smiseth OA (2005) New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 112(20):3149–3156

    Article  PubMed  Google Scholar 

  4. Garot J, Pascal O, Diebold B, Derumeaux G, Gerber BL, Dubois-Rande JL, Lima JA, Gueret P (2002) Alterations of systolic left ventricular twist after acute myocardial infarction. Am J Physiol Heart Circ Physiol 282(1):H357–H362

    CAS  PubMed  Google Scholar 

  5. Takeuchi M, Nishikage T, Nakai H, Kokumai M, Otani S, Lang RM (2007) The assessment of left ventricular twist in anterior wall myocardial infarction using two-dimensional speckle tracking imaging. J Am Soc Echocardiogr 20(1):36–44

    Article  PubMed  Google Scholar 

  6. Bansal M, Leano RL, Marwick TH (2008) Clinical assessment of left ventricular systolic torsion: effects of myocardial infarction and ischemia. J Am Soc Echocardiogr 21(8):887–894

    Article  PubMed  Google Scholar 

  7. Helle-Valle T, Remme EW, Lyseggen E, Pettersen E, Vartdal T, Opdahl A, Smith HJ, Osman NF, Ihlen H, Edvardsen T, Smiseth OA (2009) Clinical assessment of left ventricular rotation and strain: a novel approach for quantification of function in infarcted myocardium and its border zones. Am J Physiol Heart Circ Physiol 297(1):H257–H267

    Article  CAS  PubMed  Google Scholar 

  8. Chaudhry FA, Tauke JT, Alessandrini RS, Vardi G, Parker MA, Bonow RO (1999) Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol 34(3):730–738

    Article  CAS  PubMed  Google Scholar 

  9. Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL (2009) Stress echocardiography expert consensus statement—executive summary: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur Heart J 30(3):278–289

    Article  PubMed  Google Scholar 

  10. Liem SS, van der Hoeven BL, Oemrawsingh PV, Bax JJ, van der Bom JG, Bosch J, Viergever EP, van Rees C, Padmos I, Sedney MI, van Exel HJ, Verwey HF, DE Atsma, van der Velde ET, Jukema JW, van der Wall EE, Schalij MJ (2007) MISSION!: optimization of acute and chronic care for patients with acute myocardial infarction. Am Heart J 153(1):14.e1–14.e11

    Article  Google Scholar 

  11. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Katus HA, Apple FS, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow JJ, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S, Morais J, Aguiar C, Almahmeed W, Arnar DO, Barili F, Bloch KD, Bolger AF, Botker HE, Bozkurt B, Bugiardini R, Cannon C, de Lemos J, Eberli FR, Escobar E, Hlatky M, James S, Kern KB, Moliterno DJ, Mueller C, Neskovic AN, Pieske BM, Schulman SP, Storey RF, Taubert KA, Vranckx P, Wagner DR (2012) Third universal definition of myocardial infarction. J Am Coll Cardiol 60(16):1581–1598

    Article  PubMed  Google Scholar 

  12. Pellikka PA, Nagueh SF, Elhendy AA, Kuehl CA, Sawada SG (2007) American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. J Am Soc Echocardiogr 20(9):1021–1041

    Article  PubMed  Google Scholar 

  13. Funaro S, La Torre G, Madonna M, Galiuto L, Scara A, Labbadia A, Canali E, Mattatelli A, Fedele F, Alessandrini F, Crea F, Agati L (2009) Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the acute myocardial infarction contrast imaging (AMICI) multicenter study. Eur Heart J 30(5):566–575

    Article  PubMed  Google Scholar 

  14. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463

    Article  PubMed  Google Scholar 

  15. van Dalen BM, Vletter WB, Soliman OI, ten Cate FJ, Geleijnse ML (2008) Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography. J Am Soc Echocardiogr 21(8):895–898

    Article  PubMed  Google Scholar 

  16. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL (2011) Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr 24(3):277–313

    Article  PubMed  Google Scholar 

  17. Taber LA, Yang M, Podszus WW (1996) Mechanics of ventricular torsion. J Biomech 29(6):745–752

    Article  CAS  PubMed  Google Scholar 

  18. Beyar R, Sideman S (1986) Left ventricular mechanics related to the local distribution of oxygen demand throughout the wall. Circ Res 58(5):664–677

    Article  CAS  PubMed  Google Scholar 

  19. Dong SJ, Hees PS, Huang WM, Buffer SA Jr, Weiss JL, Shapiro EP (1999) Independent effects of preload, afterload, and contractility on left ventricular torsion. Am J Physiol 277(3 Pt 2):H1053–H1060

    CAS  PubMed  Google Scholar 

  20. Notomi Y, Martin-Miklovic MG, Oryszak SJ, Shiota T, Deserranno D, Popovic ZB, Garcia MJ, Greenberg NL, Thomas JD (2006) Enhanced ventricular untwisting during exercise: a mechanistic manifestation of elastic recoil described by Doppler tissue imaging. Circulation 113(21):2524–2533

    Article  PubMed  Google Scholar 

  21. Moon MR, Ingels NB Jr, Daughters GT 2nd, Stinson EB, Hansen DE, Miller DC (1994) Alterations in left ventricular twist mechanics with inotropic stimulation and volume loading in human subjects. Circulation 89(1):142–150

    Article  CAS  PubMed  Google Scholar 

  22. Picano E, Lattanzi F, Orlandini A, Marini C, L’Abbate A (1991) Stress echocardiography and the human factor: the importance of being expert. J Am Coll Cardiol 17(3):666–669

    Article  CAS  PubMed  Google Scholar 

  23. Rizzello V, Poldermans D, Boersma E, Biagini E, Schinkel AF, Krenning B, Elhendy A, Vourvouri EC, Sozzi FB, Maat A, Crea F, Roelandt JR, Bax JJ (2004) Opposite patterns of left ventricular remodeling after coronary revascularization in patients with ischemic cardiomyopathy: role of myocardial viability. Circulation 110(16):2383–2388

    Article  PubMed  Google Scholar 

  24. Braunwald E, Rutherford JD (1986) Reversible ischemic left ventricular dysfunction: evidence for the “hibernating myocardium”. J Am Coll Cardiol 8(6):1467–1470

    Article  CAS  PubMed  Google Scholar 

  25. White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ (1987) Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 76(1):44–51

    Article  CAS  PubMed  Google Scholar 

  26. St John Sutton M, Pfeffer MA, Plappert T, Rouleau JL, Moye LA, Dagenais GR, Lamas GA, Klein M, Sussex B, Goldman S (1994) Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. Circulation 89(1):68–75

    Article  Google Scholar 

  27. Pfeffer MA, Braunwald E (1990) Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation 81(4):1161–1172

    Article  CAS  PubMed  Google Scholar 

  28. van Dalen BM, Soliman OI, Vletter WB, Kauer F, van der Zwaan HB, ten Cate FJ, Geleijnse ML (2009) Feasibility and reproducibility of left ventricular rotation parameters measured by speckle tracking echocardiography. Eur J Echocardiogr 10(5):669–676

    Article  PubMed  Google Scholar 

  29. Sengupta PP, Khandheria BK, Narula J (2008) Twist and untwist mechanics of the left ventricle. Heart Fail Clin 4(3):315–324

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

E. Joyce is financially supported by a European Society of Cardiology training grant and by a bursary from the Irish Board for Training in Cardiovascular Medicine sponsored by Merck Sharp & Dohme. D. Leong is supported by the National Health and Medical Research Council of Australia and the National Heart Foundation of Australia. G. Hoogslag received a PhD grant provided by the Leiden University Medical Center. P. Debonnaire is supported by a Sadra Medical Research grant (Boston Scientific) and holds a European Association of Cardiovascular Imaging (EACVI) Research grant for 2013. The Department of Cardiology received grants from Biotronik, Medtronic, Boston Scientific Corporation, St Jude Medical, Sadra Lotus and GE Healthcare. V. Delgado received consulting fees from St. Jude Medical and Medtronic.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Emer Joyce, Darryl P. Leong, Georgette E. Hoogslag, Philippe Debonnaire, Elena Abate, Eduard R. Holman, Martin J. Schalij, Jeroen J. Bax, Victoria Delgado & Nina Ajmone Marsan

  2. Discipline of Medicine, University of Adelaide and Flinders University, Adelaide, Australia

    Darryl P. Leong

  3. Department of Cardiology, University Hospital Antwerp, Edegem, Belgium

    Paul L. van Herck

Authors
  1. Emer Joyce
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Darryl P. Leong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgette E. Hoogslag
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul L. van Herck
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Philippe Debonnaire
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elena Abate
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eduard R. Holman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Martin J. Schalij
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jeroen J. Bax
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Victoria Delgado
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nina Ajmone Marsan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nina Ajmone Marsan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Joyce, E., Leong, D.P., Hoogslag, G.E. et al. Left ventricular twist during dobutamine stress echocardiography after acute myocardial infarction: association with reverse remodeling. Int J Cardiovasc Imaging 30, 313–322 (2014). https://doi.org/10.1007/s10554-013-0351-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-013-0351-2

Keywords

Search

Navigation