Related Experiment Videos
Aortoseptal angulation and left ventricular hypertrophy pattern: an echocardiographic study in patients with aortic
E M Gross-Sawicka1, H M Nagi, H M Lever
1Department of Heart and Hypertension Research, Cleveland Clinic Foundation, OH 44195-5069.
Insights
Aortic stenosis can alter heart shape. A wider aortoseptal angle in patients with aortic stenosis is linked to better left ventricular outflow tract dimensions, potentially reducing obstruction risk after surgery.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Mechanics
Background:
- Valvular aortic stenosis is a significant cardiovascular condition.
- Left ventricular (LV) geometry is crucial for cardiac function.
- Aortoseptal angulation's impact on LV changes in aortic stenosis requires further elucidation.
Purpose of the Study:
- To investigate the influence of aortoseptal angulation on left ventricular alterations in patients with valvular aortic stenosis.
- To assess the relationship between diastolic aortoseptal angle and left ventricular outflow tract (LVOT) dimensions.
Main Methods:
- Utilized M-mode, two-dimensional, and Doppler echocardiography in 15 patients with valvular aortic stenosis.
- Categorized patients into two groups based on diastolic aortoseptal angle (Group I: 118°±4°, Group II: 96°±17°).
- Measured and compared left ventricular outflow tract diameter and correlated aortoseptal angulation with LV indexes.
Main Results:
- A significantly narrower LVOT diameter was observed in Group II (96°±17° angle) compared to Group I (118°±4° angle).
- Two patients in Group II developed severe LVOT obstruction post-surgery.
- Diastolic aortoseptal angulation correlated with LV diastolic posterior wall thickness in Group II (r = -0.975, p = 0.025).
Conclusions:
- Aortoseptal angulation can modify left ventricular geometry in patients with aortic stenosis.
- The clinical significance of aortoseptal angulation may involve its effect on postoperative LVOT obstruction.
- Understanding this relationship can aid in surgical risk assessment and patient management.
Abstract:
We studied 15 patients with valvular aortic stenosis (mean age 63 +/- 14 [SD] years) with M-mode, two-dimensional, and Doppler echocardiography to evaluate the influence of aortoseptal angulation on left ventricular changes. The diastolic aortoseptal angle averaged 118 degrees +/- 4 degrees in 10 patients (group I) and 96 degrees +/- 17 degrees in five patients (group II) (p less than 0.05). Left ventricular outflow tract diameter was significantly narrower in group II versus group I (1.5 +/- 0.5 cm versus 2.1 +/- 0.2 cm, p less than 0.01), and severe left ventricular outflow tract obstruction developed in two patients in group II after surgery. Moreover, diastolic aortoseptal angulation did not correlate with any of left ventricular indexes in group I but correlated significantly with left ventricular diastolic posterior wall thickness in group II (r = -0.975, p = 0.025). We conclude that aortoseptal angulation in aortic stenosis may alter left ventricular geometry, and its clinical significance may be related to its effects on postoperative accentuation of left ventricular outflow tract obstruction.