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Indirect ultrasound evaluation of left ventricular outflow tract diameter implications for heart failure and aortic

Gabriele Pestelli1,2, Andrea Fiorencis3, Valeria Pergola4

  • 1Cardiology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.

Echocardiography (Mount Kisco, N.Y.)
|May 26, 2021
PubMed

Insights

A new formula predicts left ventricular outflow tract diameter (LVOTD) using aortic root and LV dimensions, improving accuracy over body surface area (BSA) alone. This enhances assessments in heart failure (HF) and aortic stenosis (AS).

Area of Science:

  • Cardiology
  • Echocardiography
  • Medical Imaging

Background:

  • Left ventricular outflow tract diameter (LVOTD) dependency on body surface area (BSA) is established.
  • The relationship between LVOTD and aortic root/left ventricular (LV) dimensions is unexplored.
  • Accurate LVOTD assessment is crucial for heart failure (HF) and aortic stenosis (AS) evaluation.

Purpose of the Study:

  • To explore the relationship between LVOTD and aortic root/LV dimensions.
  • To develop a novel predictive equation for LVOTD incorporating these dimensions.
  • To compare the novel equation with the existing BSA-derived formula.

Main Methods:

  • A cohort of 540 HF patients underwent transthoracic echocardiography.
  • Patients were divided into derivation (N=340) and validation (N=200) subgroups.
  • A regression equation was derived using independent determinants of LVOTD and validated.

Main Results:

  • Sinuses of Valsalva diameter (SVD), BSA, LV end-diastolic diameter (LVEDD), and height were independent LVOTD determinants.
  • The novel regression equation (LVOTD = 6.209 + [0.201 × SVD] + [1.802 × BSA] + [0.03 × LVEDD] + [0.025 × Height]) showed high correlation with measured LVOTD (R=0.739).
  • The novel equation performed significantly better than the BSA-derived formula.

Conclusions:

  • Aortic root and LV dimensions independently influence LVOTD.
  • A new comprehensive equation incorporating these dimensions improves LVOTD prediction.
  • This advancement aids LV output evaluation in HF and AS severity assessment when direct measurement is challenging.
Abstract

Keywords:
aortic stenosisechocardiographyheart failureleft ventricular outflow tractstroke distancestroke volume

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