Annular excursion contributes to efficient cardiac output: a three-dimensional echocardiographic approach

Area of Science:

• Cardiovascular imaging
• Cardiac mechanics
• Echocardiography

Background:

• The heart's efficiency relies on the coordinated movements of diastole and systole.
• Three-dimensional (3D) echocardiography enables detailed evaluation of cardiac motion and morphology.

Purpose of the Study:

• To assess mitral and aortic annulus excursions towards the left ventricular apex using 3D echocardiography.
• To determine the impact of annulus excursion on cardiac function by measuring angular variations between the mitral and aortic valves throughout the cardiac cycle.

Main Methods:

• Compared 3D echocardiography data from seven healthy adolescents (Group H) and seven patients with dilated cardiomyopathy (Group D).
• Quantified annulus excursion (AE), annulus excursion volume (AEV), and the ratio of AEV to left ventricular diastolic volume (AEV/EDV).
• Measured angular variations (Dmax, Dmin, Dmax-min) between the mitral and aortic annuli during the cardiac cycle.

Main Results:

• Annulus excursion (AE) was significantly greater in healthy adolescents (Group H) compared to dilated cardiomyopathy patients (Group D).
• The ratio of annulus excursion volume to end-diastolic volume (AEV/EDV) was significantly higher in Group H than in Group D.
• The change in angle between the mitral and aortic annuli (Dmax-min) throughout the cardiac cycle was significantly greater in Group H.

Conclusions:

• Annulus excursion plays a crucial role in achieving efficient cardiac output.
• Greater angle variation between the mitral and aortic annuli was observed in healthy adolescents, suggesting its importance in normal cardiac function.
• 3D echocardiography is a valuable tool for understanding 'motional cardiac morphology'.