• Christian Prinz, Lothar Faber, Dieter Horstkotte, Hermann Körperich, Axel Moysich, Nikolaus Haas, Deniz Kececioglu, and Thorsten Laser Kai K 2 Center of Congenital Heart Disease, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany..
• 1 Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
• Cardiol Young. 2014 Apr 1; 24 (2): 245-52.

AimsTo evaluate the role of torsion in hypertrophic cardiomyopathy in children.MethodsA total of 88 children with idiopathic hypertrophic cardiomyopathy (n = 24) and concentric hypertrophy (n = 20) were investigated with speckle-tracking echocardiography and compared with age- and gender-matched healthy controls (n = 44).ResultsIn hypertrophic cardiomyopathy, we found increased torsion (2.8 ± 1.6 versus 1.9 ± 1.0°/cm [controls], p < 0.05) because of an increase in clockwise basal rotation (-8.7 ± 4.3° versus -4.9 ± 2.5° [controls], p < 0.001) and prolonged time to peak diastolic untwisting (3.7 ± 2.4% versus 1.7 ± 0.6% [controls] of cardiac cycle, p < 0.01), but no differences in peak untwisting velocities. Hypertrophic cardiomyopathy patients demonstrated a negative correlation between left ventricular muscle mass and torsion (r = -0.7, p < 0.001). In concentric hypertrophy, torsion was elevated because of increased apical rotation (15.1 ± 6.4° versus 10.5 ± 5.5° [controls], p < 0.05) without correlation with muscle mass. Peak untwisting velocities (- 202 ± 88 versus -145 ± 67°/s [controls], p < 0.05) were higher in concentric hypertrophy and time to peak diastolic untwisting was delayed (1.8 ± 0.8% versus 1.2 ± 0.6% [controls], p < 0.05).ConclusionsIn contrast to an increased counterclockwise apical rotation in concentric hypertrophy, hypertrophic cardiomyopathy is characterised by predominantly enhanced systolic basal clockwise rotation. Diastolic untwisting is delayed in both groups. Torsion may be an interesting marker to guide patients with hypertrophic cardiomyopathy.

22 keywords...

hide…