Right Ventricular Segmental Rotation and Torsion in Normal Subjects Evaluated by 2D Speckle Tracking Echocardiography

Yang, Hyun Suk; Mookadam, Farouk; Khandheria, Bijoy; Chandrasekaran, Krishnaswamy; Yang, Hyun Suk; Mookadam, Farouk; Khandheria, Bijoy; Chandrasekaran, Krishnaswamy

Clin Ultrasound > Accepted Articles

Hyun Suk Yang¹

, Farouk Mookadam², Bijoy K. Khandheria², Krishnaswamy Chandrasekaran²

¹Konkuk University Medical Center, Seoul, Korea
²Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, United States

Address for Correspondence:

Hyun Suk Yang ,Tel: 82-10-7523-0864, Fax: 82-2-2030-7748, Email: yang.hyun@gmail.com

Received: 4 October 2022; Accepted: 12 October 2022. Published online: 12 October 2022.

ABSTRACT

Background: Right ventricular (RV) torsion is not well-defined due to its complex anatomy. The present study was designed to assess RV's global and segmental torsional motion in subjects without cardiac pathologies.
Method:
We used the Vivid 7 ultrasound system (GE Healthcare, Chicago, IL USA) for acquiring parasternal short-axis views of the RV at the basal and apical levels and analyzed global and segmental torsion using the 2D speckle-tracking algorithm in EchoPAC workstation software.
Results:
Forty-eight individuals (44±17 years, male 54%) were included, with either normal LV diastolic function (group I, n=40) or grade I diastolic dysfunction (group II, n=8). Group I showed systolic counterclockwise rotation at the apex (7.7±6.2 degrees) and clockwise rotation at the base (-1.2±2.8 degrees) of the RV, resulting in global peak systolic torsion of 9.0±6.6 degrees with higher segmental torsion in the mid-interventricular septum (IVS) than anterior walls (P=0.001). Global RV torsion showed a very strong positive correlation with apical rotation (r=0.91, P=0.001). Group I revealed higher segmental torsion in the anterior-IVS and mid-IVS walls than group II (9.8±7.1 vs. 3.5±9.6 degrees, P=0.036; 10.4±9.1 vs. 2.4±12.3 degrees, P=0.038, respectively).
Conclusions:
Analysis of RV segmental torsion was feasible using a 2D-speckle tracking algorithm. Apical rotation can be used as a simplified index of global RV torsion. Further studies are needed to evaluate its clinical impact in various disease states.

Keywords: two-dimensional speckle tracking; echocardiography; right ventricle; torsion