Added Value of Rotational Mechanics to Longitudinal Indices in the Risk Stratification of Patients With Left Ventricular Hypertrophy

INTRODUCTION: In the past, analysis of the rotational mechanics of the left ventricle (LV) has been complicated by a confusing codification system and also because it has been approached independently from myocardial function state. We hypothesized that, once global longitudinal strain (GLS) is altered as early sign of myocardial involvement, rotational mechanics is a determining factor in LV ejection fraction (LVEF) in patients with LV hypertrophy (LVH). METHODS: 16%, and 175 with GLS < 16 %). We prospectively evaluated the subjects´ RG values according to GLS and LVEF state. RESULTS: 13.4° predicted a LVEF < 50% [AUC 0.92 (95% CI: 0.87-0.96; p < 0.001), sensitivity 82.5% and specificity 92.5%], and a rigid rotation pattern was associated with the lowest LVEF values. CONCLUSIONS: Rotational mechanics should be interpreted based on myocardial function state. In patients with GLS < 16% a smaller RG is associated with lower LVEF. RG can be used to stratify patients with LVH at risk of heart failure.