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Diastolic aortic root motion in left ventricular hypertrophy
Insights
Left ventricular hypertrophy (LVH) alters aortic root motion, reducing the atrial emptying index (AEI). This echocardiographic finding offers a rapid method for assessing altered left ventricular filling in patients with LVH.
Area of Science:
- Cardiology
- Echocardiography
- Physiology
Background:
- Aortic root motion is linked to left atrial function.
- Left ventricular hypertrophy (LVH) can affect diastolic filling patterns.
Purpose of the Study:
- To investigate if LVH alters posterior aortic root motion.
- To assess the utility of the atrial emptying index (AEI) in identifying altered diastolic filling in LVH.
Main Methods:
- Echocardiograms of 60 patients with LVH (due to aortic stenosis, hypertrophic subaortic stenosis, hypertension) were compared to 36 normal subjects.
- Analyzed posterior aortic root motion during diastole.
- Calculated the atrial emptying index (AEI).
Main Results:
- Patients with LVH showed attenuated, less abrupt diastolic posterior aortic root motion.
- The AEI was significantly reduced in patients with LVH (p < 0.001).
- AEI did not differentiate severity of hypertrophy.
Conclusions:
- Altered posterior aortic root motion is characteristic of LVH.
- The AEI is a valuable, visually assessed index for identifying altered left ventricular filling in LVH.
- AEI provides a rapid qualitative assessment of diastolic function.
Abstract:
The echocardiographic motion of the aortic root reflects, in part, left atrial filling and emptying. The echocardiograms of 60 patients with left ventricular hypertrophy (LVH) secondary to aortic stenosis, hypertrophic subaortic stenosis, and hypertension were compared with those of 36 normal subjects to determine whether the alterations of early rapid diastolic filling associated with LvH would alter motion of the posterior aortic root. Patients with LVH had a characteristic echographic pattern of motion of the posterior aortic root manifested by the attenuation of normal abrupt diastolic posterior aortic root motion. The atrial emptying index (AEI), defined as the fraction of passive posterior aortic wall motion occurring in the first third of diastole, was significantly reduced in patients with LVH (p less than 0.001), but did not discriminate among mild, moderate, and marked hypertrophy. The AEI may be useful in the identification of altered left ventricular filling associated with LVH. The changes associated with a decreased AEI are readily appreciated by visual inspection and provide a rapid method of qualitatively assessing left ventricular filling properties.