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Longitudinal change, gender difference and hemodynamic implications of aortoseptal angle in adults without structural
Ling-Yun Kong1, Fang Liu1, Ling-Ling Chen1
1Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Insights
The aorto-septal angle (AoSA) steepens with age, male sex, and sigmoid interventricular septum. Females show a wider AoSA before 70, with no gender difference thereafter.
Area of Science:
- Cardiology
- Cardiac Anatomy
- Geriatric Medicine
Background:
- The aorto-septal angle (AoSA) is a cardiac morphologic descriptor.
- Previous research on AoSA's hemodynamic significance focused on patients with structural heart disease.
- Longitudinal changes and clinical correlates of AoSA in healthy adults are not well understood.
Purpose of the Study:
- To investigate the longitudinal changes in AoSA in adults without structural heart disease.
- To identify independent clinical correlates of AoSA in this population.
- To explore gender-specific differences in AoSA over the lifespan.
Main Methods:
- Prospective study of 140 adults aged 20-90 years without structural heart disease.
- Assessment of AoSA and its correlation with age, sex, sigmoid interventricular septum (IVS), electrocardiographic QRS axis, and aortic velocity.
- Statistical analysis to determine independent predictors and associations.
Main Results:
- Advanced age, male sex, and sigmoid IVS were independent predictors of a steeper AoSA.
- Females had a wider AoSA than age-matched males before 70 years, with no significant gender difference beyond 70.
- A steeper AoSA correlated with leftward deviation of the electrocardiographic QRS axis; no significant association was found with aortic velocity.
Conclusions:
- AoSA undergoes significant longitudinal changes in healthy adults, influenced by age, sex, and cardiac structure.
- Electrocardiographic QRS axis deviation is associated with AoSA, suggesting potential functional implications.
- Further multi-center prospective studies are warranted to validate these findings and explore clinical relevance.
Abstract:
This is an era of function evaluation for heart, but still there are some structural changes remains to be recognized. Aorto-septal angle (AoSA) is a morphologic description of the heart and adjacent major vessel. Previous studies have shown its potential hemodynamic significance, however, these are conducted in patients with structural heart diseases. The present study investigated its longitudinal change in 140 adults without structural heart disease from 20 to 90 years old and its independent clinical correlates. The findings included: 1. Advanced age, male and presence of sigmoid IVS were independent predictors of a steep AoSA. 2. Females tend to have a wider AoSA compared to age-matched males before 70 years old but they undergo more dramatic decrease with aging so that no gender difference was found beyond 70 years old. 3. Electrocardiographic QRS axis left deviation tends to be correlated with a steeper AoSA. 4. In adults without structural heart disease, no clinically significant association between AoSA and aortic velocity was found. Further prospective study from multi-centers is needed to verify these findings.
