О.М. Trembovetska, G.V. Knyshov, V.P. Zakharova.Study of features of left ventricular wall rotational motion in patients with dilated cardiomyopathy using speckle tracking echocardiography .

The aim – to study the features of rotational motion of left ventricular walls in patients with dilated cardiomyopathy.
Material and methods. 70 patients with dilated cardiomyopathy and 35 patients without cardiac pathology have been involved into the study. General clinical examination and echocardiography, including speckle tracking echocardiography, have been carried out. Patients with dilated cardiomyopathy have been subdivided into 2 groups according to absence or presence of complete left bundle branch block.
Results. Normal left ventricular basal and apical rotation constituted –4.3±1.3 °, and 10.5±0.6 °, respectively. Decrease of both basal rotation by 37 % and apical rotation by 64 %, in comparison with normal rates, have been observed in patients with dilated cardiomyopathy and without total left bundle-branch block (Group I). Basal and apical rotation were in the opposite directions. Moderate decrease of basal rotation, constituting 2.6±1.7 °, which is 40 % lower the normal rates, have been observed in patients with dilated cardiomyopathy and with complete left bundle branch block (Group II). At the same time the apical rotation was in the same direction as the basal one, with angle of rotation of –2.±1.5 °, which is significantly lower than normal rates by 122 %.
Conclusions. Normal left ventricular basal and apical rotation is in the opposite directions, i.e., basal rotation is clockwise and apical rotation is counter-clockwise. In dilated cardiomyopathy the rotational capacity of left ventricular myocardium is sharply decreased, and, additionally, in occurrence of total left bundle-branch block the direction of apical rotation is changed. The significant decrease of apical rotation and change of its direction in patients with dilated cardiomyopathy with total left bundle-branch block leads to increase of heart failure.

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