Left ventricular systolic torsion is correlated to right ventricular dilation in pulmonary hypertension patients

Abstract

Background: Left ventricular systolic torsion is a primary mechanism contributing to stroke volume. RV function plays a key role in the prognosis of the disease and can be assessed by the ratio RV end-diastolic area/ LV end-diastolic area ratio (RVEDA/LVEDA). We hypothesized that left ventricular systolic torsion can be affected in pulmonary hypertension patients and correlates right ventricular dilation. Methods: 44 patients were prospectively included. They all underwent clinical examination, right heart catheterization, usual and 2D strain echocardiography. Left ventricular torsion was calculated as the maximum difference between the apical and basal rotation of the left ventricle. We measured left ventricular ejection fraction, right ventricular and left ventricular areas during systole and diastole. Results: 44 simultaneous measurements were obtained. At baseline: MPAP was 38± 12 mmHg, PAPO was 10± 3 mmHg, cardiac index was: 3.2± 1 L/min/m2, RVEDA/LVEDA was 1.08 ± 0.68, left ventricular apical rotation was: 9± 5°, left ventricular basal rotation was: 6± 3° and left ventricular torsion was 12± 7°. In patients with MPAP higher than 35 mmHg, left ventricular torsion was significantly correlated to the ratio RV end-diastolic area/ LV end-diastolic area ratio (p = 0.02). Conclusion: We concluded that left ventricular torsion which plays a key role in left ventricular systolic function and stroke volume is affected in PH patients with MPAP higher than 35 mmHg and is correlated to right ventricular dilation.