Left Ventricular Motion Patterns Research Articles

Left ventricular systolic motion pattern differs among patients with left bundle branch block patterns.

The study aimed to investigate left ventricular (LV) motion pattern in patients with LBBB patterns including patients with pacemaker rhythm (PM), type B Wolff-Parkinson-White syndrome (B-WPW), premature ventricular complexes originating from the right ventricular outflow tract (RVOT-PVC), and complete left bundle branch block (CLBBB). Two-dimensional speckle tracking was used to evaluate peak value and time to peak value of the LV twist, LV apex rotation, and LV base rotation in patients with PM, B-WPW, RVOT-PVC, and CLBBB with normal LV ejection fraction, and in age-matched control subjects. The LV motion patterns were altered in all patients compared to the control groups. Patients with PM and CLBBB had a similar LV motion pattern with a reduced peak value of LV apex rotation and LV twist. Patients with B-WPW demonstrated the opposite trend in the reduction of LV rotation peak value, which was more dominant in the basal layer. The most impairment in the LV twist/rotation peak value was identified in patients with RVOT-PVC. Compared to the control group, the apical-basal rotation delay was prolonged in patients with CLBBB, followed by those with B-WPW, PM, and RVOT-PVC. The LV motion patterns were different among patients with different patterns of LBBB. CLBBB and PM demonstrated a reduction in LV twist/rotation that was pronounced in the apical layer, B-WPW showed a reduction in the basal layer, and RVOT-PVC in both layers. CLBBB had the most pronounced LV apical-basal rotation dyssynchrony.

Normal left ventricular twist in patients with non-compaction cardiomyopathy, or in normal subjects with hypertrabeculation?

We read with great interest the article by Pacileo et al. ,1 recently published in the European Journal of Echocardiography. The authors described normal left ventricular (LV) twist in 14 patients with non-compaction cardiomyopathy (NCCM). This finding is in sharp contrast to severely impaired LV twist described in larger series by us2,3 and others.4 Also, an abnormal LV motion pattern called ‘rigid body …

Detailed analysis of myocardial motion in volunteers and patients using high‐temporal‐resolution MR tissue phase mapping

To detect and investigate details in left ventricular (LV) motion patterns with a temporal resolution comparable to that of echocardiography. To assess global and regional myocardial motion in high temporal detail, respiratory-gated MR phase-contrast measurements with three-directional velocity encoding (venc) were performed in 12 healthy volunteers and two patients with LV hypertrophy in basal, midventricular, and apical locations of the LV with a temporal resolution of 13.8 msec. The volunteer data revealed details in LV motion patterns that were known only from echocardiography. For all volunteers, characteristic myocardial motion patterns, such as triphasic global diastolic expansion, could be detected with high accuracy. One volunteer underwent an additional echocardiographic measurement in order to corroborate the complex motion features as measured by MRI. Patient examinations revealed substantial changes in diastolic function compared to motion patterns in healthy volunteers. The proposed high-temporal-resolution velocity-mapping technique provides previously undetectable information on LV performance, and is highly promising for the detection of local and global motion abnormalities in patients with disturbed LV performance, such as diastolic dysfunction.

Investigating myocardial motion by MRI using tissue phase mapping

Velocity-encoded phase contrast magnetic resonance imaging (MRI) provides a tool to quantify regional myocardial wall motion of the entire heart. It allows the acquisition of three-directional velocity vector fields with high spatial resolution that reflect the temporal evolution of myocardial velocities over the cardiac cycle. In contrast to other imaging modalities such as echocardiography left ventricular performance can be assessed without limited anatomical or functional coverage. Compared to other techniques that quantify local myocardial contractility (e.g. implanted ultrasonic crystals) by means of regional displacement, phase contrast MRI provides information about local and global left ventricular velocities (i.e. motion) by utilizing the intrinsic motion sensitivity of MRI. The resultant motion components of contraction, expansion, rotation, lengthening, and shortening of the left ventricle are described in high spatial and temporal detail. Phase contrast measurements were performed in 12 healthy volunteers with a respiratory-gated technique in order to achieve a high temporal resolution of 13.8ms to demonstrate the detailed assessment of global and regional myocardial motion. Data revealed details in left ventricular motion patterns that were previously not seen in phase contrast measurements and are only known from echocardiography. For all volunteers, characteristic myocardial motion patterns and locally different radial (i.e. contraction and expansion), rotational (i.e. twisting and untwisting) and longitudinal (i.e. lengthening and shortening) motion components could be detected with high accuracy. The phase contrast MRI technique for high temporal resolution velocity mapping is therefore very promising for the investigation and better understanding of the myocardial motion in normal subjects and patients with disturbed left ventricular performance and may validate further testing of different models of cardiac structure.

Navigator gated high temporal resolution tissue phase mapping of myocardial motion

Data acquisition for phase contrast velocity mapping of myocardial motion is typically based on multiple breath-held 2D measurements with limited acquisition duration and consequently relatively poor temporal resolution. In order to overcome the limitations of breath-hold acquisitions, an improved navigator-guided technique was implemented based on 2 navigator signals within each cardiac cycle in combination with paired acceptance and rejection criteria of successive navigator signals. Respiratory gated phase contrast measurements with 3-directional velocity encoding were performed in 12 healthy volunteers in basal, midventricular, and apical locations of the left ventricle during free breathing with a temporal resolution of 13.8 ms. Results were compared to standard breath-hold measurements with a temporal resolution of 69 ms. Data from the high temporal resolution study revealed details in left ventricular motion patterns that were previously not seen in phase contrast measurements and are only known from echocardiography. The proposed navigator gated technique for high temporal resolution velocity mapping is, therefore, highly promising for the detection of local and global motion abnormalities in patients with disturbed left ventricular performance, such as diastolic dysfunction.