PMID- 22918406
OWN - NLM
STAT- MEDLINE
DCOM- 20130919
LR  - 20221207
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 14
IP  - 4
DP  - 2013 Apr
TI  - Time to twist: marker of systolic dysfunction in Africans with hypertension.
PG  - 358-65
LID - 10.1093/ehjci/jes175 [doi]
AB  - AIMS: Speckle-tracking echocardiography (STE) has emerged as a quantitative 
      technique to assess left ventricular (LV) function via twist mechanics. 
      Hypertension-associated changes in LV twist have not been previously evaluated in 
      African patients with LV systolic dysfunction. This study evaluates LV twist 
      dynamics in hypertensive patients with a low ejection fraction (EF). METHODS AND 
      RESULTS: Forty-one hypertensive patients with EF <45% and normal coronary 
      angiography (HTLEF group) were compared with 41 control subjects using STE. Peak 
      apical rotation (AR) and isochronous basal rotation (BR) were measured, as was 
      net twist (maximal value of simultaneous AR-BR). Rigid body rotation (RBR) was 
      defined as AR and BR occurring in the same direction. Of 41 HTLEF patients, 28 
      (68%) had normal twist pattern, whereas 13 (32%) exhibited RBR; 11 of those 13 
      exhibited clockwise rotation. AR (1.89 degrees  +/- 0.99 vs. 7.15 degrees  +/- 2.26; P < 0.0001), BR 
      (1.44 degrees  +/- 0.78 vs. -3.75 degrees  +/- 1.61; P < 0.0001), and net twist (3.3 degrees  +/- 1.17 vs. 
      10.9 degrees  +/- 2.7; P < 0.0001) were lower in HTLEF patients. The subgroup with 
      clockwise RBR showed greater LV dysfunction (EF: 27.9 +/- 5.8 vs. 35 +/- 7.5%; P = 
      0.005) and more spherical LV geometry in both diastole and systole (P = 0.0009 
      and P = 0.0002, respectively) compared with those who had a normal pattern of 
      twist. In the HTLEF subgroup with normal twist pattern, AR (r = 0.57; P = 0.002) 
      and net twist (r = 0.57; P = 0.002) correlated with EF. CONCLUSIONS: LV twist in 
      patients with hypertension and EF <45% is diminished. Apical rotation and net 
      twist are good correlates for EF in hypertensive patients with EF <45%.
FAU - Maharaj, Nirvarthi
AU  - Maharaj N
AD  - Division of Cardiology, Chris Hani Baragwanath Hospital and University of the 
      Witwatersrand, Johannesburg, South Africa.
FAU - Khandheria, Bijoy K
AU  - Khandheria BK
FAU - Peters, Ferande
AU  - Peters F
FAU - Libhaber, Elena
AU  - Libhaber E
FAU - Essop, Mohammed R
AU  - Essop MR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120822
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Adult
MH  - Black or African American/*statistics & numerical data
MH  - Cardiac Output, Low/diagnostic imaging/physiopathology
MH  - Cross-Sectional Studies
MH  - Echocardiography, Doppler/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Systolic/*diagnostic imaging/ethnology/etiology
MH  - Humans
MH  - Hypertension/*complications/diagnosis/ethnology
MH  - Male
MH  - Middle Aged
MH  - Reference Values
MH  - Risk Assessment
MH  - Rotation
MH  - Severity of Illness Index
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/ethnology/etiology
EDAT- 2012/08/25 06:00
MHDA- 2013/09/21 06:00
CRDT- 2012/08/25 06:00
PHST- 2012/08/25 06:00 [entrez]
PHST- 2012/08/25 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
AID - jes175 [pii]
AID - 10.1093/ehjci/jes175 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2013 Apr;14(4):358-65. doi: 10.1093/ehjci/jes175. 
      Epub 2012 Aug 22.