Regional assessment of left ventricular torsion by CMR tagging

Rüssel, Götte, Kuijer, Marcus

Description

Purpose To introduce a standardized method for calculation of left ventricular torsion by CMR tagging and to determine the accuracy of torsion analysis in regions using an analytical model. Methods Torsion between base and apex, base and mid, and mid and apex levels was calculated using CSPAMM tagging and Harmonic Phase tracking. The accuracy of torsion analysis on a regional basis (circumferential segments and transmural layers) was analyzed using an analytical model of a deforming cylinder with a displaced axis of rotation (AoR). Regional peak torsion values from twelve healthy volunteers calculated by the described method were compared to literature. Results The deviation from the analytical torsion per % AoR-displacement (of the radius) was 0.90 ± 0.44% for the circumferential segments and only 0.05% for the transmural layers. In the subjects, circumferentially, anterolateral torsion was larger than inferior (12.4 ± 3.9° vs. 5.0 ± 3.3°, N.S.). Transmurally, endocardial torsion was smaller than epicardial (7.5 ± 1.3° vs. 8.0 ± 1.5°, p < 0.001). Conclusion Variability in the position of the AoR causes a large variability in torsion in circumferential segments. This effect was negligible for global torsion, and torsion calculated in transmural layers. Results were documented for the healthy human heart and are in agreement with data from literature.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2008
• Nombre de lectures: 2
• Langue: English

Extrait

Journal of Cardiovascular Magnetic Resonance

BioMedCentral

Open Access Research Regional assessment of left ventricular torsion by CMR tagging 1 21 1 Iris K Rüssel*, Marco J Götte, Joost P Kuijerand J Tim Marcus

1 Address: Dept.of Physics and Medical Technology, Vrije Universiteit Medical Center, De Boelelaan 11181081 HV Amsterdam,the Netherlands 2 and Dept.of Cardiology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands Email: Iris K Rüssel*  [e-mail]; Marco J Götte  [e-mail]; Joost P Kuijer  [e-mail]; J Tim Marcus  [e-mail] * Corresponding author

Published: 27 May 2008Received: 19 May 2008 Accepted: 27 May 2008 Journal of Cardiovascular Magnetic Resonance2008,10:26 doi:10.1186/1532-429X-10- 26 This article is available from: http://www.jcmr-online.com/content/10/1/26 © 2008 Rüssel et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Purpose:To introduce a standardized method for calculation of left ventricular torsion by CMR tagging and to determine the accuracy of torsion analysis in regions using an analytical model. Methods:Torsion between base and apex, base and mid, and mid and apex levels was calculated using CSPAMM tagging and Harmonic Phase tracking. The accuracy of torsion analysis on a regional basis (circumferential segments and transmural layers) was analyzed using an analytical model of a deforming cylinder with a displaced axis of rotation (AoR). Regional peak torsion values from twelve healthy volunteers calculated by the described method were compared to literature. Results:The deviation from the analytical torsion per % AoR-displacement (of the radius) was 0.90 ± 0.44% for the circumferential segments and only 0.05% for the transmural layers. In the subjects, circumferentially, anterolateral torsion was larger than inferior (12.4 ± 3.9° vs. 5.0 ± 3.3°, N.S.). Transmurally, endocardial torsion was smaller than epicardial (7.5 ± 1.3° vs. 8.0 ± 1.5°, p < 0.001). Conclusion:Variability in the position of the AoR causes a large variability in torsion in circumferential segments. This effect was negligible for global torsion, and torsion calculated in transmural layers. Results were documented for the healthy human heart and are in agreement with data from literature.

Introduction Torsion is the wringing motion induced by contracting myofibers in the left ventricular (LV) wall, in order to eject blood from the ventricle. The subsequent fast untwisting during early diastole is a major indicator of the restoring forces that contribute to rapid filling, since the blood is actively sucked from the left atrium [1] into the LV.

Subendo and subepicardial myofibers are obliquely ori ented in opposite directions, with a smooth, transmural transition between the fiber directions [2]. Since torsion is

directly related to myofiber orientation, structure, and function, it is an important indicator for the condition of the heart. Torsion was found to be a sensitive marker for both systolic and diastolic dysfunction [310]. This may allow for an early differentiation between diseased and normal myocardium, and discrimination between systolic and diastolic heart failure.

However, no uniform method to calculate torsion is yet available. There is still a debate on how to describe and analyze LV torsion in an optimal way. Several methods to

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