Assessment Of Rotation And Torsion Of Left Ventricle In Patients With Mitral Prosthetic Mechanical Valve Replacement By Speckle Tracking Imaging

Objective:Using speckle tracking imaging(STI) to assess the rotation and torsion of left ventricle in patients with mitral valve replacement(MVR) with prosthetic mechanical valve.Methods:This study included21patients with MVR or DVR(double-valve replacement) and25normal control ones. Contrast the peak systolic rotation of subendocardial layer and subepicardial layer and global lever in left ventricular basal and apical lever which was measured by STI, and the torsion calculated in different layer meanwhile between two groups. Analyse the correlation between systolic rotation and torsion of subendocardial layer and subepicardial layer and global lever and LVEF, LVDd and LA. The MVR group was divided into some sub-group according the modus operandi, the time after operation, LVEF, and their rotation and torsion were analysized. Results:1. Compaired with the normal ones, the LVEF of MVR group was significantly reduced(P=0.002). The systolic rotation of subendocardial layer(P=0.010) and subepicardial layer(P=0.003) and global lever(P=0.003) were significantly reduced in left ventricular apical lever, and the systolic torsion of subendocardial layer(P=0.006) and subepicardial layer(P=0.002) and global lever(P=0.002) were significantly reduced, while the rotation in basal lever was not statistically reduced(P>0.05).2. Moderate correlation were noted between systolic maximum rotation of both subepicardial layer and global lever in basal and apical lever and LVEF. Moderate correlation were noted between the torsion of left ventricle and LVEF. Moderate correlation were noted between each rotation in apical lever or torsion of left ventricle and LVDd.3. Data was analysized within the MVR group:the systolic torsion in LVEF<60%group were significantly reduced(P<0.01).Conclusions:Compared with the normal, the patients with the MVR of prosthetic mechanical valve manifested as the depression of LVEF. The rotation and torsion of left ventricle were reduced, while the apical lever and global lever were much more obviously reduced than the basal lever, especially in subepicardial layer. The rotation and torsion of left ventricle interacted with LVEF, and the correlation between those in subepicardial layer and LVEF was the best. While the cardiac function impaired, so did left ventricular rotation and torsion.