Age-related Changes in the Left Ventricular Twist

Year 2017, Volume: 20 Issue: 2, 125 - 129, 01.08.2017

Sabiye Yılmaz , Harun Kılıç Saadet Demirtaş Mehmet Bülent Vatan Efe Edem Mustafa Tarık Ağaç Mustafa Türker Pabuccu Mehmet Akif Çakar Mustafa Gökhan Vural Murat Aksoy Ersan Tatlı Hüseyin Gündüz Ramazan Akdemir

Abstract

Introduction:
Left
ventricular (LV) rotation and twist play important roles in LV contraction and
relaxation. Systolic function is usually preserved with aging, but diastolic
function deteriorates. The aim of this study was to establish a reference value
for LV twist and examine the effect of aging on it.

Patients
and Methods: We enrolled 75 healthy subjects who were divided into
two groups according to age: < 40 and > 40 years. LV rotation and twist
were assessed with two-dimensional speckle tracking imaging at the basal and
apical levels of the parasternal short axis. LV twist was defined as an apical
rotation relative to the baseline. Exclusion criteria included a history of
ischemic and valvular disease, arrhythmia, use of a pacemaker, and systolic
dysfunction.

Results: Peak A
wave velocity (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001) and E/E’ratio (7.7 ±
2.2 vs. 6.1 ± 1.3, p< 0.001) were higher and peak E wave velocity (52.4 ± 16
vs. 76.8 ± 11, p< 0.001) and E/A ratio (0.75 vs. 1.34, p< 0.001) were
lower in old patients than in young patients. There was an increase in apical
rotation (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) and a decrease in basal rotation
(−4.1 ± 2.7° vs. −5.2 ± 3.7°, p= 0.185) in old patients, but these changes
indicated no significant difference. With aging, the twist increased (8.6 ±
3.3° vs. 8.5 ± 4.1°, p= 0.890), but not significantly. LV apical rotation (5 ±
3.2 vs. 2.4 ± 1.1, p= 0.004) and twist (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64)
decreased in the old group with an increasing degree of LV diastolic
dysfunction.

Conclusion: LV twist slightly increased
with age, but this effect was reversed with increased diastolic dysfunction
even in the presence of normal systolic function.

Keywords

Echocardiography, rotation and twist, aging

Sol Ventrikül Bükülme Hareketinde Yaşa Bağlı Değişiklikler

Abstract

Giriş: Sol ventrikül (LV) rotasyon ve büküm hareketi kasılma ve
gevşemede önemli rol oynamaktadır. Yaşlanma ile LV sistolik fonksiyonları
korunsada diyastolik fonksiyonlar genellikle bozulur. Bu çalışmanın amacı, LV
büküm için bir referans değeri saptamak ve yaşlanmanın büküm üzerinde
etkilerini incelemekti.

Hastalar ve Yöntem: Çalışmaya 75 sağlıklı kişi
dahil edildi; katılımcılar 40 yaş üstü ve 40 yaş altı olarak iki gruba ayrıldı.
LV rotasyon ve büküm parasternal kısa eksen bazal ve apikal seviyelerinde 2D-STI
ile değerlendirildi. LV büküm hareketi apikal ve bazal rotasyonun göreceli
toplamı olarak tanımlandı. İskemik ve kapak hastalığı, aritmi, kalp pili ve
sistolik disfonksiyon öyküsü dışlama kriterleri olarak tanımlandı. 

Bulgular: Yaşlılarda gençlere kıyasla pik A dalga hızı (70.6 ±
13.7 vs. 57.7 ± 10.6, p< 0.001), E/E’ oranı (7.7 ± 2.23 vs. 6.09 ± 1.3,
p< 0.001) daha yüksek, pik E dalga hızı (52.4 ± 16 vs. 76.75 ± 11, p<
0.001), E/A oranı (0.75 vs. 1.34, p< 0.001) daha düşüktü. Yaşlı grupta
apikal rotasyonda artış (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) ve bazal
rotasyonda azalma (-4.1 ± 2.7° vs. 3.7°± -5.2, p= 0.185) izlendi ancak, bu
değişiklikler anlamlı değildi. Yaşlanma ile birlikte, büküm önemsiz derecede
arttı (8.6 ± 3.3° vs. 8.53 ± 4.1°, p= 0.890). Yaşlı grupta LV diyastolik
disfonksiyon derecesi arttıkça apikal rotasyon (5.02 ± 3.2 vs. 2.4 ± 1.1, p=
0.004) ve büküm (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) azaldı.

Sonuç: Bu çalışma LV bükümün
yaşla birlikte hafifçe arttığını, ancak bu etkinin sistolik fonksiyonları
normal olsada artmış diyastolik disfonksiyon varlığında tersine döndüğünü
gösterdi.

Keywords

Ekokardiyografi, rotasyon ve büküm, yaşlanma

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