Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography

The Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands Submitted 15 May 2008 ; accepted in final form 19 August 2008 The increasing number and proportion of aged individuals in the population warrants knowledge of normal physiological changes of left ventricular (LV) biomechanics with advancing age. LV twist describes the instantaneous circumferential motion of the apex with respect to the base of the heart and has an important role in LV ejection and filling. This study sought to investigate the biomechanics behind age-related changes in LV twist by determining a broad spectrum of LV rotation parameters in different age groups, using speckle tracking echocardiography (STE). The final study population consisted of 61 healthy volunteers (16–35 yr, n = 25; 36–55 yr, n = 23; 56–75 yr, n = 13; 31 men). LV peak systolic rotation during the isovolumic contraction phase (Rot early ), LV peak systolic rotation during ejection (Rot max ), instantaneous LV peak systolic twist (Twist max ), the time to Rot early , Rot max , and Twist max , and rotational deformation delay (defined as the difference of time to basal Rot max and apical Rot max ) were determined by STE using QLAB Advanced Quantification Software (version 6.0; Philips, Best, The Netherlands). With increasing age, apical Rot max ( P < 0.05), time to apical Rot max ( P < 0.01), and Twist max ( P < 0.01) increased, whereas basal Rot early ( P < 0.001), time to basal Rot early ( P < 0.01), and rotational deformation delay ( P < 0.05) decreased. Rotational deformation delay was significantly correlated to Twist max ( R 2 = 0.20, P < 0.05). In conclusion, Twist max increased with aging, resulting from both increased apical Rot max and decreased rotational deformation delay between the apex and the base of the LV. This may explain the preservation of LV ejection fraction in the elderly. aging; left ventricular function Address for reprint requests and other correspondence: M. L. Geleijnse, Erasmus Univ. Medical Center, The Thoraxcenter, Rm. BA 302, ‘s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands (e-mail: m.geleijnse{at}erasmusmc.nl )