Left ventricular torsion in patients with secundum atrial septal defect.

Background: Recently, assessment of left ventricular (LV) torsional deformation has become an important approach for quantifying LV function. This study sought to evaluate LV torsion using speckle tracking imaging in patients with atrial septal defect (ASD).
Methods and Results: Basal and apical LV short-axis images were analyzed in 45 asymptomatic adults with isolated secundum ASD and 45 matched normal subjects. The apical rotation parameters were similar between 2 groups; however, the peak basal clockwise rotation was significantly depressed (-5.4 +/-2.8 degrees vs -6.9 +/-2.6 degrees , P<0.001) and time to the peak was significantly delayed (118.3 +/-18.8% vs 96.1 +/-12.6% of systolic period, P<0.001) in patients with ASD. The peak basal initial counterclockwise rotation in the ASD group was significantly higher (5.1 +/-3.3 degrees vs 1.8 +/-1.4 degrees , P<0.001) and longer (75.4 +/-26.7% vs 42.5 +/-24.4% of systolic period, P<0.001) than that in the control group. LV peak twist was also reduced significantly in patients with ASD (11.9 +/-5.9 degrees vs 14.6 +/-3.5 degrees , P<0.05) in comparison with the controls.
Conclusions: LV systolic twist was significantly reduced in patients with ASD mainly because of the heterogeneous basal rotation.