Mayo Clinic research recognizes rare disorder of heart's wringing motion

Wednesday, January 30, 2008

SCOTTSDALE, Ariz. — About 4.8 million Americans have heart failure, with about 550,000 new cases being diagnosed each year. But not all forms of heart failure are due to primary disorders of the heart muscle.

In some patients the pericardium, a covering around the heart muscle – also referred to as its "cradle" – can become thickened, encasing and constricting the heart in a concrete shell-like covering. This can become dangerously inflexible, preventing the heart from expanding when blood enters it, causing heart failure. "Differentiating pericardial constriction from other types of heart's muscle disease remains a major clinical challenge because both conditions clinically imitate each other, says Dr. Bijoy Khandheria, chair, Mayo Clinic Cardiovascular Services, researcher and senior author of the study. "However, the clinical management differs widely. Patients with constriction generally need early cardiac surgery to restore heart's function."

Mayo Clinic researchers have described a new application of high-resolution imaging methodology called "speckle tracking," which uses sound waves for measuring the wringing motion of the left ventricle. In a normal heart, the wringing motion helps to expel blood from its chambers, while the uncoiling of the muscle helps by filling the chambers with blood.

"Interestingly we found that the wringing motion in subjects with constriction was far more reduced than other forms of heart failure" said Dr. Partho P. Sengupta, lead author of the study. Dr. Sengupta received funding from the American Society of Echocardiography to investigate this specific problem. "Loss of wringing motion would explain loss of suction power, although the heart muscle inside the thickened shell may work normally," added Dr. Sengupta, further highlighting the significance of heart's wringing motion.

Earlier published information by Dr. Khandheria and colleagues proposed a redefinition of how the human heart functions – a discovery that can also lead to treatment of heart failure. "This study extends our earlier observations and emphasizes use of new, evolved imaging techniques for better planning for heart surgeries to correct rare abnormalities of failing hearts," Dr. Khandheria notes.

Other Mayo researchers participating in the project were Vijay K. Krishnamoorthy, Walter P. Abhayaratna, Josef Korinek, Marek Belohlavek, Thoralf M. Sundt, III, Krishnaswamy Chandrasekaran, Farouk Mookadam, James B. Seward, and A. Jamil Tajik. The findings of this study were published in January 2008 issue of Journal of American College of Cardiology: Imaging.

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Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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