[Hemodynamic correlation of the systolic movement of the aortic root]

Factors influencing the anterior systolic movement of the aortic posterior wall (PAM) are complex and still controversial. Left atrial events seem to be more important that stroke volume or left ventricular function in determining PAM. Even if the reduction of systolic aortic movement is generally associated to a severe impairment of left ventricular function, very few studies correlate the changes in the amplitude of aortic systolic movement to the hemodynamic pattern. In 50 patients posterior aortic wall echocardiograms, right heart catheterization and 99mTc angiocardiography were performed within 24 h. According to hemodynamic and left ventricular wall motion parameters 18 patients resulted to have a normal (1st group) and 32 patients (2nd group) an impaired left ventricular function. In the 2nd group mean values of PAM were significantly lower than in the 1st group (7.4 +/- 2.9 mm vs 10.2 +/- 1.9 mm). A significant correlation was found between PAM and hemodynamic parameters, i.e. CPW (r = 0.58), EF (r = 0.58) and SV (r = 0.40), whereas no significant correlations were found between these parameters and left atrial dimensions and between PAM and left atrial dimensions. A high significant correlation was found between PAM and echocardiographically measured septal wall motion (r = 0.80). All patients with PAM Less Than 6 mm and echo septal wall motion Less Than 5 mm had an akinesis or a dyskinesis of septal wall quantitatively determined with 99mTc angiocardiography. These findings suggest that one of the main determinants of PAM is left ventricular wall motion and in particular left ventricular septal motion.