PMID- 20956489
OWN - NLM
STAT- MEDLINE
DCOM- 20101108
LR  - 20161125
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 96
IP  - 21
DP  - 2010 Nov
TI  - Left ventricular rotational mechanics in patients with coronary artery disease: 
      differences in subendocardial and subepicardial layers.
PG  - 1737-43
LID - 10.1136/hrt.2010.197533 [doi]
AB  - OBJECTIVE: Subendocardial and subepicardial layers have opposite orientation of 
      the myofibres and they are differently affected by coronary artery disease. This 
      study investigated the differences in subendocardial and subepicardial left 
      ventricular (LV) twist in patients with coronary artery disease. METHODS: 214 
      patients were included in the study: 60 with first ST elevation myocardial 
      infarction (STEMI), 111 with chronic ischaemic heart failure (HF) and 43 normal 
      subjects. Real-time three-dimensional echocardiography provided LV volumes and 
      function. Two-dimensional speckle tracking echocardiography differentiating the 
      subendocardial and subepicardial layers was used for the assessment of LV twist. 
      Patients with STEMI were divided into two groups (small and large STEMI). 
      RESULTS: Compared with normal subjects, peak subendocardial LV twist was 
      significantly impaired in patients with STEMI (11.2 +/- 6.0 degrees  vs 15.3 +/- 2.7 degrees , 
      p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more 
      impaired (4.6 +/- 3.4 degrees , p<0.001 vs normal subjects and patients with STEMI). 
      Conversely, peak subepicardial LV twist was not statistically different between 
      normal subjects and patients with STEMI (8.9 +/- 1.9 degrees  vs 8.4 +/- 4.4 degrees , p=0.98), 
      whereas it was significantly impaired in patients with chronic HF (2.6 +/- 2.5 degrees , 
      p<0.001 vs normal subjects and patients with STEMI). Peak subendocardial LV twist 
      was not statistically different between large and small STEMI, whereas peak 
      subepicardial LV twist was significantly lower in large STEMI than in small STEMI 
      (7.1 +/- 4.8 degrees  vs 9.6 +/- 3.6 degrees , p=0.025). CONCLUSIONS: Subendocardial LV twist is 
      reduced in patients with STEMI and chronic ischaemic HF whereas subepicardial LV 
      twist is reduced only in chronic ischaemic HF. When STEMI are divided into large 
      and small infarctions, it becomes evident that subepicardial LV twist is only 
      reduced in large infarctions.
FAU - Bertini, Matteo
AU  - Bertini M
AD  - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 
      ZA Leiden, The Netherlands.
FAU - Delgado, Victoria
AU  - Delgado V
FAU - Nucifora, Gaetano
AU  - Nucifora G
FAU - Ajmone Marsan, Nina
AU  - Ajmone Marsan N
FAU - Ng, Arnold C T
AU  - Ng AC
FAU - Shanks, Miriam
AU  - Shanks M
FAU - Antoni, M Louisa
AU  - Antoni ML
FAU - van de Veire, Nico R L
AU  - van de Veire NR
FAU - van Bommel, Rutger J
AU  - van Bommel RJ
FAU - Rapezzi, Claudio
AU  - Rapezzi C
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - Bax, Jeroen J
AU  - Bax JJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Disease/*complications
MH  - Echocardiography, Three-Dimensional/methods
MH  - Endocardium/physiopathology
MH  - Female
MH  - Heart Failure/complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications
MH  - Pericardium/physiopathology
MH  - Prospective Studies
MH  - Torsion Abnormality/diagnostic imaging/*etiology
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*etiology
EDAT- 2010/10/20 06:00
MHDA- 2010/11/09 06:00
CRDT- 2010/10/20 06:00
PHST- 2010/10/20 06:00 [entrez]
PHST- 2010/10/20 06:00 [pubmed]
PHST- 2010/11/09 06:00 [medline]
AID - 96/21/1737 [pii]
AID - 10.1136/hrt.2010.197533 [doi]
PST - ppublish
SO  - Heart. 2010 Nov;96(21):1737-43. doi: 10.1136/hrt.2010.197533.