LEFT VENTRICLE MECHANICS IN THE FIRST THIRD SISTOLE IN HEALTHY CHILDREN BORN FULL-TERM

The aim of the study is to assess the left ventricle rotation and twist in the first third of the systole in healthy children and adolescents born full-term.

Material and Methods. The analysis was carried out in 108 healthy children aged 5 months to 18 years, born full-term, who belonged to the health groups I–II. Prior to inclusion in the study, nobody has suffered and acute respiratory viral infections in the past 6 months Depending on the age, children and adolescents were divided into the following subgroups: from 5 months to 3 years, 3 to 6 years, 6 to 11 years and over 11 years. On the basis of the sex ratio, the distinguished sub-groups of children did not differ among themselves. Left ventricle rotation is assessed at the level of basal segments, papillary muscles, apex segments and left ventricle twisting in the first third of the systole and towards the end of the systole.

Results. Left ventricle rotation in the first third of the systole at the level of the basal segments was recorded in 75.9% of healthy children who had type I of left ventricle twist and in 29.4% of healthy children with the second type of left ventricle twist. Left ventricle rotation at the level of the apical segments was revealed — in 20.37% of children with type I left ventricle twist. The phenomenon of «lack of left ventricle twist in the first third of the systole» was found in 12.96% of healthy children and adolescents born full-term at the age before 4 years. The presence of this phenomenon did not depend on the type of left ventricle twist at the end of systole, the left ventricle sphericity index at the end of systole and diastole of left ventricle. In the phenomenon of «lack of left ventricle twist in the first third of the systole», the time to the peak rate of left ventricle twist rate in systole is less than 85 ms.

1. Henson R. E., Song S. K., Pastorek J. S., Ackerman J. J. H., Lorenz C. H. Left ventricular torsion is equal in mice and human. Am. J. Physiol. Heart Circ. Physiol. 2000; 278: H1117–1123.

2. Opdahl A., Helle-Valle T., Remme E. W., Vartdal T., Pettersen E., Lunde K., Edvardsen T., Smiseth O. A. Apical Rotation by Speckle Tracking Echocardiography: A Simplified Bedside Index of Left Ventricular Twist. J. Am. Soc. Echocardiogr. 2008; 21: 1121–1128.

3. Тorrent-Guasp F., Buckberg G. D., Clemente C., Cox J. L., Coghlan H. C., Gharib M. The Structure and Function of the helical heart and Its Buttress Wrapping. I. The Normal Macroscopic structure of the Heart. Thorac. Cardiovasc. Surg. 2001; 13(4): 301–319.

4. Sengupta P. P., Tajik A. J., Chandrasekaran K., Khandheria B. K. Twist mechanics of the left ventricle: Principles and application. J. Am. Coll. Cardiol. Imaging. 2008; 1: 366–376.

5. Shaw S. M., Fox D. J., Williams S. G. The development of left ventricular torsion and its clinical relevance. Int. J. Cardiol. 2008; 130: 319–325.

6. Wang J., Khoury D. S, Yue Y., Torre-Amione G., Nagueh S. F. Left ventricular untwisting rate by speckle tracking echocardiography. Circulation. 2007; 116: 2580–2586.

7. Steine K., Stugaard M., Smiseth O. A. Mechanisms of retarded apical filling in acute ischemic left ventricular failure. Circulation. 1999; 99: 2048–2054.

8. Davis K. L., Mehlhorn U., Schertel E. R., Geissler H. J., Trevas D., Laine G. A., Allen S. J. Variation in tau, the time constant for isovolumic relaxation, along the left ventricular base-to-apex axis. Basic Res. Cardiol. 1999; 94: 41–48.

9. Notomi Y., Martin-Miklovic M. G., Oryszak S. J., Shiota T., Deserranno D., Popovic Z. B., Garcia M. J., Greenberg N. L., Thomas J. D. Enhanced ventricular untwisting during exercise: a mechanistic manifestation of elastic recoil described by Doppler tissue imaging. Circulation. 2006; 113(21): 2524–2533.

10. Kaku K., Takeuchi M., Tsang W., Yasukochi S., Patel A. R., Mor-Avi V., Lang R. M., Otsuji Y. Age-related normal range of left ventricular strain and torsion using three-dimensional speckle-tracking echocardiography. J. Am. Soc. Echocardiogr. 2014; 27(1): 55–64.

11. Zhang L., Zhang J., Han W., Gao J., He L., Yang Y., Yin P., Xie M., Ge S. Three dimensional relation, twist and torsion analyses using real-time 3D speckle tracking imaging: feasibility, reproducibility, and normal ranges in pediatric population. PLOS ONE. July 18, 2016. Режим доступа: http://dx.doi.org/10.1371/journal. pone.0158679.

12. Kim C. S., Park S., Eun L. Y. Myocardial rotation and torsion in child growth. J. Cardiovasc. Ultrasound. 2016; 24(3): 223–228.

13. Al-Naami G. H. Torsion of young hearts: a speckle tracking study of normal infants, children, and adolescents. Eur. J. Echocardiogr. 2010; 11(10): 853–862.

14. James A., Corcoran J. D., Mertens L., Franklin O., El-Khuffash A. Left ventricular rotational mechanics in preterm infants less than 29 weeks’ gestation over the first week after birth. J. Am. Soc. Echocardiogr. 2015; 28: 808–817.

15. Павлюкова Е. Н., Колосова М. В., Унашева А. И., Карпов Р. С. Ротация и скручивание левого желудочка у здоровых детей и подростков, рожденных доношенными. Ультразвуковая и функциональная диагностика. 2017; 1: 39–53 [Pavlyukova E. N., Kolosova M. V., Unasheva A. I., Karpov R. S. Left ventricle rotation and twist in children and adolescents born full-term. Ultrasonic and functional diagnostics. 2017; 1: 39–53] (In Russ).

16. Унашева А. И., Павлюкова Е. Н., Колосова М. В. Типы скручи- вания левого желудочка у здоровых детей и подростков. Си- бирский медицинский журнал. 2017; 1: 14–19 [Unasheva A. I., Pavljukova E. N., Kolosova M. V. Types of twisting of the left ventricle in healthy children and adolescents, Siberian Medical Journal. 2017; 1: 14–19] (In Russ).

17. Lai W. W., Geva T., Shirali G. S., Frommelt P. C., Humes R. A. Brook M. M., Pignatelli R. H., Rychik J. Task Force of the Pediatric Council of the American Society of Echocardiography; Pediatric Council of the American Society of Echocardiography. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J. Am. Soc. Echocardiogr. 2006; 19(12): 1413–1430.

18. Lang R. M., Badano L. P., Mor-Avi V., Afilalo J., Amstrong A., Ernande L., Flachskampf F. A., Foster E., Goldstein S. A., Kuznetsova T., Lancellotti P., Muraru D., Picard M. H., Rietzschel E. R., Rudski L., Spencer K. T., Tsang W., Voigt J. U. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 2015; 28(1): 1–39.

19. Helle-Valle T., Crosby J., Edvardsen T., Smiseth O. A., New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation. 2005; 112: 3149–3156.

20. Notomi Y., Lysyansky P., Setser R. M., Shiota T., Popovic Z. B., Martin-Miklovic M. G., Weaver J. A., Oryszak S. J., Greenberg N. L., White R. D., Thomas J. D. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J. Am. Coll. Cardiol. 2005; 45(12): 2034–2041.

21. Park S. J., Miyazaki C., Bruce C. J., Ommen S., Miller F. A., Oh J. K. Left ventricular torsion by two-dimensional speckle tracking echocardiography in patients with diastolic dysfunction and normal ejection fraction. J. Am. Soc. Echocardiogr. 2008; 21(10): 1129–1137.

22. Kim H. J., Ji-Hong Yoon J.-H., Lee E.-J., Han J. Normal Left Ventricular Torsion Mechanics in Healthy Children: Age Related Changes of Torsion Parameters Are Closely Related to Changes in Heart Rate. Korean Circ. J. 2015; 45(2): 131–140.

23. Lorenz C. H., Pastorek J. S., Bundy J. M. Delineation of normal human left ventricular twist throughout systole by tagged cine magnetic resonance imaging. J. Cardiovasc. Magn. Reson. 2000; 2: 97–108.

24. Takahashi K., Al Naami G., Thompson R., Inage A., Mackie A. S., Smallhorn J. F. Normal rotational, torsion and untwisting data in children, adolescents and young adults. J. Am. Soc. Echocardiogr. 2010; 23: 286–293.

25. Kim H. K., Sohn D. W., Lee S. E., Choi S., Park J., Kim Y., Oh B., Park Y., Choi Y. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J. Am. Soc. Echocardiogr. 2007; 20: 45–53.

26. Van Dalen B. M., Soliman O. I., Vletter W. B., ten Cate F. J., Geleijnse M. L. Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography. Am. J. Physiol. Heart. Circ. Physiol. 2008; 295: H1705–1711.

27. Rademakers F. E., Buchalter M. B., Rogers W. J. Dissociation between left ventricular untwisting and filling. Circulation. 1992; 85: 572–1581.

28. Ashikaga H., Coppola B. A., Hopenfeld B., Leifer E. S., McVeigh E. R., Omens J. H. Transmural dispersion of myofiber mechanics: implications for electrical heterogeneity in vivo. J. Am. Coll. Cardiol. 2007; 49: 909–916.

29. Макаренко И. В. Роль полиморфизма тайтина в регуляции структурно-функциональных свойств миокарда в норме и при патологии: автореферат дис. … канд. биол. наук. Пущино, 2004: 20 [Makarenko I. V. The role of titin polymorphism in the regulation of structural and functional properties of the myocardium in normal and pathological conditions: autoabstract candidate’s dissertation of biological science. Pushhino, 2004: 20] (In Russ).

30. Chen M. P., Li S. N., Lam W. W., Ho Y. C., Ha S. Y., Chan G. C., Cheung Y. F. Left ventricular torsional mechanics and myocardial iron load in beta-thalassaemia major: a potential role of titin degradation. BMC Cardiovasc. Disord. 2014; 12(14): 49.

31. Maskatia S. A., Lee W., Altman C. A., Ayres N. A., Feagin D. K., Pignatelli R. H. Left ventricular rotational mechanics in early infancy: Normal reference ranges and reproducibility of peak values and time to peak values. Early Human Development. 2017; 104: 39–44.