A New Coding System for the Identification of Left Ventricular Rotation Patterns and Their Relevance to Myocardial Function

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Vicente Mora, Juan Geraldo, Ildefonso Roldán, Ester Galiana, Celia Gil, Pablo Escribano, Rosina Arbucci, Alberto Hidalgo, Paula Gramage, Jorge Trainini, Francesc Carreras, Jorge Lowenstein
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Abstract

Rotational mechanics is a fundamental determinant of left ventricular ejection fraction (LVEF). The coding system currently employed in clinical practice does not distinguish between rotational patterns. We propose an alternative coding system that makes possible to identify the rotational pattern of the LV and relate it to myocardial function. Echocardiographic images were used to generate speckle tracking-derived transmural global longitudinal strain (tGLS) and rotational parameters. The existence of twist (basal and apical rotations in opposite directions) is expressed as a rotational gradient with a positive value that is the sum of the basal and apical rotation angles. Conversely, when there is rigid rotation (basal and apical rotations in the same direction) the resulting gradient is assigned a negative value that is the subtraction between the two rotation angles. The rotational patterns were evaluated in 87 healthy subjects and 248 patients with LV hypertrophy (LVH) and contrasted with their myocardial function. Our approach allowed us to distinguish between the different rotational patterns. Twist pattern was present in healthy controls and 104 patients with LVH and normal myocardial function (tGLS ≥ 17%, both). Among 144 patients with LVH and myocardial dysfunction (tGLS < 17%), twist was detected in 83.3% and rigid rotation in 16.7%. LVEF was < 50% in 34.7%, and all patients with rigid rotation had a LVEF < 50%. The gradient rotational values showed a close relationship with LVEF (r = 0.73; p < 0.001). The proposed coding system allows us to identify the rotational patterns of the LV and to relate their values with LVEF.

Abstract Image

用于识别左心室旋转模式及其与心肌功能相关性的新编码系统
旋转力学是左心室射血分数(LVEF)的基本决定因素。目前临床上使用的编码系统并不能区分旋转模式。我们提出了另一种编码系统,可以识别左心室的旋转模式,并将其与心肌功能联系起来。超声心动图图像用于生成斑点追踪衍生的跨膜全局纵向应变(tGLS)和旋转参数。扭转(基底和心尖旋转方向相反)的存在表现为旋转梯度,其正值为基底和心尖旋转角度之和。相反,当存在刚性旋转(基底和根尖旋转方向相同)时,所产生的梯度为负值,即两个旋转角度的减数。我们对 87 名健康受试者和 248 名左心室肥厚(LVH)患者的旋转模式进行了评估,并与他们的心肌功能进行了对比。我们的方法使我们能够区分不同的旋转模式。在健康对照组和 104 名左心室肥厚且心肌功能正常的患者(tGLS 均≥ 17%)中存在扭曲模式。在 144 名患有左心室功能不全和心肌功能障碍的患者中(tGLS
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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