P747Is torsion a predictor for severeness of LV-hypertrophy?


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Abstract

Background: In the course of patients with left ventricular hypertrophy diastolic as well as systolic function can be affected resulting in abnormal cardiac deformation patterns. The role of torsion in this contex remains controversial, especially in the pediatric age.Method: Patients with hypertrophic cardiomyopathy (HCM, n=24, 14,1±5,5y), concentric LV-hypertrophy due to increased afterload (CH, n=24,12,7±6,1y) as well as body surface area matched healthy children for each patient group (Norm) were investigated with speckle tracking echocardiography (Vivid 7, Echopac, 2D-Strain, GE). Demographic data, basal and apical rotational values and their timing were compared using Student's T-Test and Pearson's coefficient of correlation.Results: In HCM we found an increase in torsion (2,71±1,67°/cm vs 2,5±1,3[CH] and 1,9±1°/cm, p<0,05[Norm]) with an increase in clockwise basal rotation (-8,7±4,32° vs -5,5±2,3°p<0,01[CH], and -4,9±2,6°, p<0,005[Norm]) with prolonged time to peak diastolic untwisting rate (3,7±2,4 % vs 1,7±0,64% of cardiac cycle, p<0,0001). Peak systolic rotation was higher in HCM than in CH (134,5±61,6°/s vs 101,5±33,4°/s, p<0,05). A negative correlation between torsion and muscle mass was only detected for HCM (r=0,78).Conclusion: Rotational behaviour in children with HCM is characterized by predominantly enhanced systolic basal clockwise rotation and increased rotation rates resulting in increased torsion. Diastolic untwisting is delayed. In HC these effects are less pronounced. Because of negative correlation with muscle mass torsion may be an interesting marker to guide patients with HCM.

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