Left ventricular rotational mechanics in patients with coronary artery disease: Differences in subendocardial and subepicardial layers

Matteo Bertini, Victoria Delgado, Gaetano Nucifora, Nina Ajmone Marsan, Arnold C.T. Ng, Miriam Shanks, M. Louisa Antoni, Nico R.L. Van De Veire, Rutger J. Van Bommel, Claudio Rapezzi, Martin J. Schalij, Jeroen J. Bax

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

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° vs 15.3±2.7°, p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more impaired (4.6±3.4°, 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° vs 8.4±4.4°, p=0.98), whereas it was significantly impaired in patients with chronic HF (2.6±2.5°, 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 twistwas significantly lower in large STEMI than in small STEMI (7.1±4.8° vs 9.6±3.6°, 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.

LanguageEnglish
Pages1737-1743
Number of pages7
JournalHeart
Volume96
Issue number21
DOIs
Publication statusPublished - 2010

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bertini, M., Delgado, V., Nucifora, G., Marsan, N. A., Ng, A. C. T., Shanks, M., ... Bax, J. J. (2010). Left ventricular rotational mechanics in patients with coronary artery disease: Differences in subendocardial and subepicardial layers. Heart, 96(21), 1737-1743. https://doi.org/10.1136/hrt.2010.197533
Bertini, Matteo ; Delgado, Victoria ; Nucifora, Gaetano ; Marsan, Nina Ajmone ; Ng, Arnold C.T. ; Shanks, Miriam ; Antoni, M. Louisa ; Van De Veire, Nico R.L. ; Van Bommel, Rutger J. ; Rapezzi, Claudio ; Schalij, Martin J. ; Bax, Jeroen J. / Left ventricular rotational mechanics in patients with coronary artery disease : Differences in subendocardial and subepicardial layers. In: Heart. 2010 ; Vol. 96, No. 21. pp. 1737-1743.
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title = "Left ventricular rotational mechanics in patients with coronary artery disease: Differences in subendocardial and subepicardial layers",
abstract = "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° vs 15.3±2.7°, p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more impaired (4.6±3.4°, 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° vs 8.4±4.4°, p=0.98), whereas it was significantly impaired in patients with chronic HF (2.6±2.5°, 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 twistwas significantly lower in large STEMI than in small STEMI (7.1±4.8° vs 9.6±3.6°, 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.",
author = "Matteo Bertini and Victoria Delgado and Gaetano Nucifora and Marsan, {Nina Ajmone} and Ng, {Arnold C.T.} and Miriam Shanks and Antoni, {M. Louisa} and {Van De Veire}, {Nico R.L.} and {Van Bommel}, {Rutger J.} and Claudio Rapezzi and Schalij, {Martin J.} and Bax, {Jeroen J.}",
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Bertini, M, Delgado, V, Nucifora, G, Marsan, NA, Ng, ACT, Shanks, M, Antoni, ML, Van De Veire, NRL, Van Bommel, RJ, Rapezzi, C, Schalij, MJ & Bax, JJ 2010, 'Left ventricular rotational mechanics in patients with coronary artery disease: Differences in subendocardial and subepicardial layers', Heart, vol. 96, no. 21, pp. 1737-1743. https://doi.org/10.1136/hrt.2010.197533

Left ventricular rotational mechanics in patients with coronary artery disease : Differences in subendocardial and subepicardial layers. / Bertini, Matteo; Delgado, Victoria; Nucifora, Gaetano; Marsan, Nina Ajmone; Ng, Arnold C.T.; Shanks, Miriam; Antoni, M. Louisa; Van De Veire, Nico R.L.; Van Bommel, Rutger J.; Rapezzi, Claudio; Schalij, Martin J.; Bax, Jeroen J.

In: Heart, Vol. 96, No. 21, 2010, p. 1737-1743.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Left ventricular rotational mechanics in patients with coronary artery disease

T2 - Heart

AU - Bertini, Matteo

AU - Delgado, Victoria

AU - Nucifora, Gaetano

AU - Marsan, Nina Ajmone

AU - Ng, Arnold C.T.

AU - Shanks, Miriam

AU - Antoni, M. Louisa

AU - Van De Veire, Nico R.L.

AU - Van Bommel, Rutger J.

AU - Rapezzi, Claudio

AU - Schalij, Martin J.

AU - Bax, Jeroen J.

PY - 2010

Y1 - 2010

N2 - 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° vs 15.3±2.7°, p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more impaired (4.6±3.4°, 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° vs 8.4±4.4°, p=0.98), whereas it was significantly impaired in patients with chronic HF (2.6±2.5°, 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 twistwas significantly lower in large STEMI than in small STEMI (7.1±4.8° vs 9.6±3.6°, 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.

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° vs 15.3±2.7°, p<0.001). In patients with chronic HF, peak subendocardial LV twist was even more impaired (4.6±3.4°, 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° vs 8.4±4.4°, p=0.98), whereas it was significantly impaired in patients with chronic HF (2.6±2.5°, 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 twistwas significantly lower in large STEMI than in small STEMI (7.1±4.8° vs 9.6±3.6°, 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.

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U2 - 10.1136/hrt.2010.197533

DO - 10.1136/hrt.2010.197533

M3 - Article

VL - 96

SP - 1737

EP - 1743

JO - Heart

JF - Heart

SN - 1355-6037

IS - 21

ER -