Assessment of left ventricular torsion in long axis view in patients with chronic stenosis of coronary arteries

Background: Left ventricular torsion is one of the most important biomechanical parameters of heart that routinely is measured in short axis view.  A review of the literature has indicated that assessment of left ventricular torsion in short axis view has some limitations. In the present study, we evaluated whether torsion angle assessment in long axis view can be used as a diagnostic biomechanical marker in patients with coronary artery disease (CAD). Methods: We assessed 20 males and 15 females who suffered from CAD and 24 healthy males and females. Two dimensional echocardiography images were scanned in cine loop format position throughout four cardiac cycles at basal and apical levels in the long axis view (4CH). Peak torsion angle in long axis view was obtained by speckle tracking method under block matching algorithm. Results: In long axis view, peak torsion angle and time of peak torsion angle were similar in females (34.87±5.8˚, 287±18ms) and males (33.26±5.60˚, 295± 22ms) while they were significantly decreased and increased in CAD patients (females: 24.91±3.5˚, 345±26ms and males:  24.15±2.16˚, 358±24 ms) in comparison to healthy subjects. The peak torsion angle reduction in CAD patients was a subsequent of   reduced rotation angle of basal and apical levels (P<0.001). Conclusion: The results showed that sex difference did not influence torsion angle of the left ventricle. It is concluded that left ventricular torsion assessment in long axis view has the potential to distinct patients with CAD from healthy subjects in routine echocardiography evaluation.