AimsThis study sought to investigate regional left ventricular (LV) rotation in patients with hypertrophic cardiomyopathy (HCM).Methods and resultsThe study comprised 44 patients with HCM with a typical reverse septal curvature (age 40 ± 14 years, 33 men) and 44 healthy volunteers (age 39 ± 14 years, 32 men) in whom LV rotation could be assessed at the basal and apical LV level with speckle-tracking echocardiography, using the QLAB Advanced Quantification Software version 6.0 (Philips, Best, The Netherlands). In HCM patients, lower values of initial counter-clockwise rotation at the basal LV level (1.5 ± 1.2 vs. 0.6 ± 0.9°, P < 0.001) were seen, in particular in the septal segment (1.7 ± 1.6 vs. 0.4 ± 0.7°, P < 0.001). After this period, the direction of rotation changed to clockwise with a peak basal rotation of -4.8 ± 2.0° in controls vs. -6.1 ± 2.5° in HCM patients (P < 0.05). Peak basal rotation in HCM patients was in particular higher in the anterior (-6.6 ± 3.0 vs. -4.4 ± 2.4°, P < 0.01) and septal (-5.4 ± 2.6 vs. -3.9 ± 1.9°, P < 0.05) segments. The normalized (corrected for peak basal rotation) global back-rotation rate was lower in HCM patients (4.1 ± 3.1 vs. 6.3 ± 4.9 s-1, P < 0.05), in particular driven by a lower rate in the septal segment (3.8 ± 2.6 vs. 6.4 ± 4.8 s -1, P < 0.01). At the apical level, changes in rotation and back-rotation were more homogeneous.ConclusionChanges in rotation and back-rotation at the LV basal level in HCM patients are mainly caused by regional changes in the basal septal and anterior segments, the segments mostly involved in the hypertrophic process. © The Author 2012.

Hypertrophic cardiomyopathy, Left ventricular rotation, Regional left ventricular function, Speckle-tracking echocardiography
dx.doi.org/10.1093/ehjci/jes163, hdl.handle.net/1765/40099
Erasmus MC: University Medical Center Rotterdam

Kauer, F, van Dalen, B.M, Soliman, O.I.I, van der Zwaan, H.B, Vletter, W.B, Schinkel, A.F.L, … Geleijnse, M.L. (2013). Regional left ventricular rotation and back-rotation in patients with reverse septal curvature hypertrophic cardiomyopathy. doi:10.1093/ehjci/jes163