Age-Related Changes in Left Ventricular Torsion Assessed by 3-Dimensional Ultrasound Speckle Tracking Imaging

Background: It is increasingly accepted that aging results in changes in left ventricular (LV) structure and function, which may play an important role in the development and progression of cardiovascular diseases. The application of 3-dimensional speckle tracking echocardiography (3D-STE) for evaluation of LV function has not been widely studied, and few data on its use for assessment of cardiac strain and torsional change with aging exist. The purpose of this study was to establish the normal values of LV torsion in healthy persons and to examine the effects of aging on these values using 3D-STE.Methods: Echocardiographic examinations were performed on 87 healthy volunteers who were divided into 3 age groups: young (20-40 years, 30 patients), middle-aged (41-59 years, 31 patients), and elderly (≥60 years, 26 patients). For the apical 3D volumetric images, torsion was analyzed in 16 myocardial segments. Using commercially available 3-dimensional torsion analysis software, time-domain speckle tracking was performed and mean values of torsion were assessed.Results: There were no statistically significant differences in body height, weight, heart rate, blood pressure, or ejection fractions between the 3 groups. A comparison of the global values of rotation, twist, and torsion revealed no differences between the 3 groups. However, regional differences were found among basal, middle, and apical segments; moreover, apical twist and apical torsion increased with age (p ＜ 0.05).Conclusions: The newly developed 3D-STE technique appears to be a reliable tool for assessment of LV regional and global function. This methodology could be applied clinically to assess alterations of myocardial function by accurately measuring regional and global LV torsion and the changes in regional heterogeneity in systolic function seen with increasing age. Our findings imply that regional function parameters may be more sensitive than global function parameters for evaluating systolic function. These results may be of value as reference data for healthy adults in further clinical studies.