Characteristics of left ventricular rotational mechanics in patients with systemic amyloidosis, systemic hypertension and normal left ventricular mass

Francesco Cappelli, Maria C. Porciani, Franco Bergesio, Federico Perfetto, Francesco De Antoniis, Ardian Cania, Francesca Tronconi, Ilaria Ricceri, Luigi Padeletti

Research output: Contribution to journalArticlepeer-review


Introduction: Recently, two-dimensional (2D) speckle-tracking echocardiography has enabled assessment of a particular behaviour of left ventricular (LV) motion defined as twisting/untwisting. The aim of our study is to evaluate whether in early stage of hypertension and systemic amyloidosis, subclinical alteration of LV twist and untwist is already present even if no LV hypertrophy is evidenced. Methods: Forty-seven patients with light chain immunoglobulin amyloidosis (AL) entered the study and were classified having cardiac amyloidosis (CA) or not (NCA) if the mean value of LV wall thickness was ≥12mm or not. Twenty-two consecutive patients with history of arterial essential hypertension (Hyp Group) and no sign of LV hypertrophy were enrolled. A total of 26 asymptomatic healthy subjects, age-matched, were analysed as control group. All three groups of patients and healthy subjects underwent traditional and 2D speckle-tracking echocardiography evaluation. LV diameters, volumes, wall thickness, mass, ejection fraction, E/A and E/E′ ratio were evaluated. Results: Twisting and untwisting rates were significantly increased in NCA and Hyp group when compared with CA and control group. Moreover, despite similar LV mass and diastolic dysfunction degree, untwisting rate peak was significantly delayed in NCA when compared with Hyp group. In patients with CA, untwisting rate delay was similar to patients with NCA. Conclusion: Our results show that amyloidosis and systemic hypertension produce both LV twist and untwist rate enhancement before LV hypertrophy is developed. In patients with amyloidosis irrespectively of LV infiltration degree, a significant LV untwisting rate peak delay occurs suggesting that different aetiology of cardiac involvement could differently affect LV untwisting rate.

Original languageEnglish
Pages (from-to)159-165
Number of pages7
JournalClinical Physiology and Functional Imaging
Issue number2
Publication statusPublished - Mar 2011


  • 2D speckle tracking
  • Amyloidosis
  • Cardiac involvement
  • Hypertension
  • LV rotational mechanics
  • LV twist
  • LV untwisting

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)


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