Preload dependency of left ventricular torsion the impact of normal saline infusion

Rory B. Weiner, Arthur E. Weyman, Abigail May Khan, Jason S. Reingold, Annabel A. Chen-Tournoux, Marielle Scherrer-Crosbie, Michael H. Picard, Thomas J. Wang, Aaron L. Baggish

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Background - Left ventricular (LV) rotation results from contraction of obliquely oriented myocardial fibers. The net difference between systolic apical counterclockwise rotation and basal clockwise rotation is left ventricular torsion (LVT). Although LVT is altered in various cardiac diseases, determinants of LVT are incompletely understood. Methods and Results-LV end-diastolic volume, LV apical and basal rotation, peak systolic LVT, and peak early diastolic untwisting rate were measured by speckle-tracking echocardiography in healthy subjects (n=8) before and after infusion of a weight-based normal saline bolus (2.1±0.3 L). Saline infusion led to a significant increase in end-diastolic LV internal diameter (45.9±3.7 versus 47.6±4.2 mm; P=0.002) and LV end-diastolic volume (90.0±21.6 versus 98.3±19.6 mL; P=0.01). Stroke volume (51.3±10.9 versus 63.0±15.5 mL; P=0.003) and cardiac output (3.4±0.8 versus 4.4±1.5 L/min; P=0.007) increased, whereas there was no change in heart rate and blood pressure. There was a significant increase in the magnitude of peak systolic apical rotation (7.5±2.4° versus 10.5±2.8°; P<;0.001) but no change in basal rotation (-4.1±2.3° versus -4.8±3.1°; P=0.44). Accordingly, peak systolic LVT increased by 33% after saline infusion (11.2±1.3° versus 14.9±1.7° P<;0.001). This saline-induced increase in LVT was associated with a marked increase in peak early diastolic untwisting rate (72.3±21.4 versus 136.8±30.0 degrees/s; P<;0.001). Conclusions-Peak systolic LVT and peak early diastolic untwisting rate are preload-dependent. Changes in LV preload should be considered when interpreting results of future LVT studies.

Original languageEnglish (US)
Pages (from-to)672-678
Number of pages7
JournalCirculation: Cardiovascular Imaging
Volume3
Issue number6
DOIs
StatePublished - Nov 1 2010
Externally publishedYes

Keywords

  • Cardiac volume
  • Echocardiography
  • Mechanics
  • Torsion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Weiner, R. B., Weyman, A. E., Khan, A. M., Reingold, J. S., Chen-Tournoux, A. A., Scherrer-Crosbie, M., Picard, M. H., Wang, T. J., & Baggish, A. L. (2010). Preload dependency of left ventricular torsion the impact of normal saline infusion. Circulation: Cardiovascular Imaging, 3(6), 672-678. https://doi.org/10.1161/CIRCIMAGING.109.932921