Twist Mechanics of the Left Ventricle Principles and Application
Twist Mechanics of the Left Ventricle Principles and Application
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DOI：
10.1016/j.jcmg.2008.02.006
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发表时间：
2008-05-01
影响因子：
14
通讯作者：
Khandheria, Bijoy K.
中科院分区：
文献类型：
--
作者：
Sengupta, Partho P.;Tajik, A. Jamil;Khandheria, Bijoy K.
左心室扭转（Left ventricular twist， LV）表示左心室尖部和底部顺时针和逆时针旋转净差的平均纵向梯度。弹射时的扭转主要使心内膜下纤维基质变形，导致势能的储存。随后扭转变形的反冲与恢复力的释放有关，这有助于左室舒张舒张和早期舒张充盈。磁共振成像和超声心动图等非侵入性技术在临床环境中有助于了解左室扭转动力学，有关其相对优点和缺陷的数据正在迅速积累。本文综述了左室扭转力学在临床心脏病学中的最新应用。首先，提出了理解心周期中左室扭转生理序列的理论框架。其次，讨论了不同实验和临床情况下左室扭转的变化。最后，本文提出了一种常规应用左室扭曲的算法，用于临床区分日常实践中遇到的左室功能障碍模式。[J]中华医学会心脏科杂志2008；1:366-76
Left ventricular (LV) twist or torsion represents the mean longitudinal gradient of the net difference in clockwise and counterclockwise rotation of the LV apex and base, as viewed from LV apex. Twist during ejection predominantly deforms the subendocardial fiber matrix, resulting in storage of potential energy. Subsequent recoil of twist deformation is associated with the release of restoring forces, which contributes to LV diastolic relaxation and early diastolic filling. Noninvasive techniques such as magnetic resonance imaging and echocardiography are useful for understanding LV twist dynamics in clinical settings, and data regarding their relative merits and pitfalls are rapidly accumulating. This review is a focused update on the current and evolving applications of LV twist mechanics in clinical cardiology. First, the theoretical framework for understanding the physiological sequence of LV twist during a cardiac cycle is presented. Second, variations in LV twist encountered in different experimental and clinical situations are discussed. Finally, the review presents an algorithm for routine application of LV twist in clinical differentiation of patterns of LV dysfunction encountered in day-to-day practice. (J Am Coll Cardiol Img 2008; 1: 366-76) (C) 2008 by the American College of Cardiology Foundation