Longitudinal Systolic Excursion of the Mitral Annular Plane and Left Ventricular Rotational Mechanics Are Associated in Healthy Adults-Three-Dimensional Speckle-Tracking Echocardiography-Derived Insights from the MAGYAR-Healthy Study.

Introduction: The rotational mechanics of the left ventricle (LV) play a significant role in maintaining systemic circulation. In clinical practice, three-dimensional speckle-tracking echocardiography (3DSTE) is one of the first methods to be used that is suitable for routine, non-invasive investigations, even in healthy individuals, allowing the conduction of extensive but easily feasible tests. In routine clinical practice, mitral annular plane systolic excursion (MAPSE) is used as an easy-to-implement parameter to judge the systolic longitudinal function of the LV; its prognostic significance is also clarified. The relationship between 3DSTE-derived LV rotational mechanics and MAPSE determined by M-mode echocardiography has never been assessed. Therefore, the aim of the present study was to investigate it extensively in healthy adults.

Methods: The present study consisted of 108 healthy adult volunteers (mean age 28.1 ± 6.3 years, 50 men). Complete two-dimensional Doppler echocardiography with MAPSE measurements and 3DSTE-derived assessment of LV rotational parameters were performed in all cases.

Results: Both the apical and basal LV rotations and the consequential LV twist showed trends toward increase, with increasing MAPSE resulting in the LV twist being largest when the MAPSE was largest. While reduced basal LV rotation was associated with reduced MAPSE, a further increase in MAPSE with increasing basal LV rotation could not be demonstrated. With an increase in apical LV rotation, a trend toward an increase in MAPSE was seen, and was largest when the apical LV rotation was largest. No correlations could be demonstrated between MAPSE and basal LV rotation and apical LV rotation.

Conclusions: Associations between LV longitudinal shortening, represented by MAPSE, and LV rotational mechanics could be demonstrated in healthy adults. These findings could have implications for assessing LV function in early disease states.