PMID- 27968775
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20170329
LR  - 20170330
IS  - 1768-3181 (Electronic)
IS  - 0003-3928 (Linking)
VI  - 65
IP  - 5
DP  - 2016 Nov
TI  - Apical rotation, a simplified index of left ventricular twist is independently 
      linked to recovery after acute anterior myocardial infarction.
PG  - 381
LID - S0003-3928(16)30373-0 [pii]
LID - 10.1016/j.ancard.2016.09.035 [doi]
AB  - BACKGROUND: It is unclear whether apical rotation (Ar), which in normal setting 
      represents the dominant contributions to LV twist by comparison to basal rotation 
      (Br), predicts viability in acute anterior myocardial infarction (AMI). Our 
      objective was to test the usefulness of Ar as a simple index to predict LV 
      recovery after AMI. METHODS: Fourty-five consecutive patients (mean age 60+/-14 
      years, mean LVEF 44+/-7%) with first AMI treated successfully by primary 
      angioplasty underwent prospectively a comprehensive transthoracic-Doppler 
      echocardiography including analysis of Ar, Br, and LV twist by 2-dimensional 
      speckle tracking, using a basal and apical short axis-views, within 24h after 
      angioplasty and 3-6months later. Recovery was defined as: - the normalization of 
      the wall motion of more than 50% of initial abnormal segments (R1) and; 
      - absolute improvement of LVEF>/=10% (R2). RESULTS: A better correlation was found 
      between Ar and LV twist at each stage of the disease than between Br and LV twist 
      (acute phase, R=0.77 vs. R=0.35; follow-up, R=0.9 vs. R=0.3 [all, P<0.001 for Ar, 
      and all, P</=0.05 for Br]). Furthermore, a better correlation was found between Ar 
      and follow-up LVEF (R=0.57), wall motion score index (R=0.44), and global 
      longitudinal strain (R=0.54) (all, P<0.001) than between LV twist and the same 
      parameters (R=0.39; R=0.32; R=0.32 respectively, all P<0.05). (For Br, all, 
      P=NS). Ar as well as LV twist were significantly associated with recovery (all, 
      P<0.01) with an area under the curve (AUC) higher for the former than for the 
      latter (R1, N=18: AUC-Ar=0.81 and AUC-LV twist=0.69, P=0.05; R2, N=19: 
      AUC-Ar=0.82, AUC-LV twist=0.75, P=0.1). In multivariate analysis, Ar remained an 
      independent predictor of recovery R1 and R2 instead of LV twist (all, P</=0.01). 
      Using a ROC curve analysis, the best cut-off of Ar to predict recovery R2 was 
      6.5 degrees , with Se=77% Sp=85%, P<0.001. CONCLUSION: Apical rotation is an independent 
      predictor of segmental and global LV recovery after anterior acute anterior 
      myocardial infarction treated successfully by primary angioplasty.
CI  - Copyright (c) 2016. Published by Elsevier SAS.
FAU - Meimoun, P
AU  - Meimoun P
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France. Electronic address: 
      patrickmeimoun.md@gmail.com.
FAU - Abouth, S
AU  - Abouth S
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Martis, S
AU  - Martis S
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Zemir, H
AU  - Zemir H
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Elmkies, F
AU  - Elmkies F
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Boulanger, J
AU  - Boulanger J
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Ahmad, G
AU  - Ahmad G
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
FAU - Clerc, J
AU  - Clerc J
AD  - Cardiologie, centre hospitalier, 60200 Compiegne, France.
LA  - eng
PT  - Journal Article
PL  - France
TA  - Ann Cardiol Angeiol (Paris)
JT  - Annales de cardiologie et d'angeiologie
JID - 0142167
EDAT- 2016/12/15 06:00
MHDA- 2016/12/15 06:01
CRDT- 2016/12/15 06:00
PHST- 2016/12/15 06:00 [entrez]
PHST- 2016/12/15 06:00 [pubmed]
PHST- 2016/12/15 06:01 [medline]
AID - S0003-3928(16)30373-0 [pii]
AID - 10.1016/j.ancard.2016.09.035 [doi]
PST - ppublish
SO  - Ann Cardiol Angeiol (Paris). 2016 Nov;65(5):381. doi: 
      10.1016/j.ancard.2016.09.035.