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Left ventricular (LV) torsion has been shown to increase with aging and in hypertensive remodeling. The relationship between longitudinal myocardial function and torsion as it relates to aging is unknown.
We studied 1,091 (mean age:75.2±5.2years, 60% female, LVEF>=50%) subjects without prevalent heart failure from the Atherosclerosis Risk in Communities (ARIC) with analyzable three-dimensional (3D) echocardiograms. LV longitudinal strain (LS) and torsion were analyzed using validated software (TomTec 4D LV-Analysis 3.0). We examined the relationship between age and these measures, as well as the influence of gender.
Advanced age was associated with greater LV concentricity, reduced LS (adjusted estimate: 0.3±0.19 SE %/10-year) and increased torsion, with the relationship between aging and torsion most pronounced in females (adjusted estimate: 0.4±0.05 SE vs 0.2±0.05 SE degree/cm/10-year, p-interaction = 0.007) (Figure). Higher blood pressure and greater LV mass-to-volume ratio were also associated with decreased LS and greater torsion in multivariable models (all p<0.05).
In a community cohort, advanced age, higher blood pressure and concentric LV remodeling were associated with worse ventricular longitudinal function, though positively related to increasing torsion, most prominent in older women. Greater LV twist/torsion may serve to compensate for diminished endocardial longitudinal function with aging, especially in women.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: LV Systolic Function
Abstract Category: 18. Imaging: Echo
Presentation Number: 1142-354
- 2013 American College of Cardiology Foundation