Correlations between echocardiographic aortic elastic properties and left ventricular rotation and twist – Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study Attila Nemes 1 , Anita Kalapos 1 ,P eter Domsik 1 , Csaba Lengyel 2 , Andrea Orosz 3 and Tam as Forster 1 1 2nd Department of Medicine and Cardiology Centre, 2 1st Department of Medicine, and 3 Department of Pharmacology and Phamacotherapy, Medical Faculty, Albert Szent-Gy € orgyi Clinical Centre, University of Szeged, Szeged, Hungary Summary Correspondence Attila Nemes, 2nd Department of Medicine and Cardiology Center, Medical Faculty, University of Szeged, H-6720, PO Box 427, Szeged, Kor  anyi fasor 6, Hungary E-mail: nemes.attila@med.u-szeged.hu Accepted for publication Received 28 September 2012; accepted 15 March 2013 Key words aortic stiffness; correlation; echocardiography; rotation; three-dimensional; twist Introduction: There is an interaction between the left ventricle (LV) and the vascular system, which plays a crucial role in determining cardiac output. LV twist could be evaluated by three-dimensional speckle-tracking echocardiography (3DSTE) as the net difference of counterclockwise apical and clockwise basal LV rotations during systole. Aortic elasticity parameters could be measured during a routine transthoracic echocardiographic examination. The current study was designed to evaluate correlations between echocardiographic aortic elastic properties and LV rotational mechanics in healthy subjects. Methods: The present study comprised 26 healthy volunteers (mean age: 34Á5 Æ 9Á8 years, 13 men). The following aortic elastic properties were mea- sured from aortic data and forearm blood pressure values: aortic strain, distensi- bility and stiffness index (ASI). 3DSTE was used to measure basal and apical LV rotations and LV twist. Results: During 3DSTE, basal LV rotation proved to be À2Á42 Æ 1Á43 degree, while apical LV rotation was 8Á56 Æ 1Á43 degree, therefore LV twist was 11Á01 Æ 5Á19 degree. Aortic strain (0Á131 Æ 0Á094), distensibility (3Á61 Æ 2Á54 cm² dynes À1 10 À6 ) and ASI (4Á08 Æ 0Á79) were also calculated. Apical LV rotation correlated with aortic distensibility (r = À0Á36, P<0Á05) and ASI (r = 0Á41, P<0Á05). LV twist showed similar correlation with ASI (r = 0Á42, P<0Á05). Discussion: Correlations exist between echocardiographic aortic elastic properties and 3DSTE-derived LV rotation and twist in healthy subjects. Introduction There is an interaction between the left ventricle (LV), as a pump, and the vascular system, as a load, which plays a crucial role in determining cardiac output (Shim, 2011). In the normal heart, the LV base rotates clockwise while the apex rotates counterclockwise during systole, producing a ‘towel-wringing’ motion of the heart. The net difference between the LV base and LV apex is called ‘net twist angle’ (Ashraf et al., 2012). The LV twist represents a phenomenon that links systolic contraction with diastolic relaxation (Urbano-Moral et al., 2011). However, little is known on the factors affecting LV rotational mechanics, even in healthy subjects. The normal human aorta is not a stiff tube, but is character- ized by elastic properties (Belz, 1995). Aortic stiffness describes the elastic resistance that the aorta sets against its distension, while the inverse of stiffness is compliance (disten- sibility), which describes the ease of systolic aortic expansion (Belz, 1995; Nemes et al., 2011). Echocardiography can be carried out for non-invasive bed- side evaluation of both aortic elastic properties and rotational mechanics, and therefore seems to be an optimal tool for clin- ical studies. Recently, three-dimensional (3D) speckle-tracking echocardiography (3DSTE) was found to be feasible for the assessment of LV rotational parameters (Urbano-Moral et al., 2011; Ammar et al., 2012). The current study was designed to evaluate correlations between echocardiographic aortic elastic Clin Physiol Funct Imaging (2013) 33, pp381–385 doi: 10.1111/cpf.12039 381 © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd 33, 5, 381–385