Abstract
BackgroundHeart failure (HF), is a major public health issue globally. Echocardiography is cost–effective in the diagnosis in expert hands. This study was conducted to estimate the usefulness of Aortic Root Systolic Excursion (ARSE) as a simple and accurate measure to estimate Left Ventricular (LV) function.MethodsThis was a cross-sectional echocardiographic study among adults aged ≥ 18 years, with or without heart failure, in sinus rhythm, and with no LV out–let obstruction. We studied the correlations of ARSE with some selected indices of LV Systolic Functions. We determined optimal cut–offs of ARSE in detecting LV dysfunction. We generated a simple regression equation to best estimate LV ejection fraction according to the modified Simpson method.ResultsOverall 213 echocardiograms were included from 106 males (49.8%), with mean age of the participants being 52.4 (SD: 18.3) years. The rate of LV systolic dysfunction was highest with Teicholz method (17.4%) and lowest with MAPSE method (5.2%). ARSE correlated with the LV functions. This was highest for the Simpson method (r = 0.619, p<0.001), and lowest for the ITV method (r = 0.319, p<0.001). Optimal cut-offs to detect LV systolic dysfunction was ≈ 6.6 mm. For an LV ejection fraction < 55%, the sensitivity was 82.9%, and the specificity was 97.2%, with an AUROC of 91.6%.The logarithmic regression equation was best in predicting LV ejection fraction (AUC: 60.2%), followed by the power model (AUC: 56.7%), and the linear model (AUC: 53.6%).ConclusionARSE correlated well with LV systolic function. The cut–off ≤ 6.5 mm suggest LV systolic dysfunction. LV Ejection Fraction was best estimated with the generic equation: LVEF (%) = 29 x In [ARSE].
Highlights
Heart failure (HF), which corroborates with high rates of hypertension and other cardiovascular risk factors is becoming an established public health issue world-wide
1: We have shown that Aortic Root Systolic Excursion (ARSE) correlates moderately with Left Ventricular (LV) systolic function indices with a good sensitivity, specificity, accuracy, predictive values, and likelihood ratios. 2: We have established that LV systolic function assessed by the modified Simpson method can best be estimated from ARSE using the modified generic equation: left ventricular ejection fraction (LVEF) (%) = 29 x In [ARSE], where ARSE is in millimeters
Aortic Root Systolic Excursion (ARSE) is an acceptable surrogate of LV systolic functions at set threshold of < 6.6 mm in predicting an LVEF < 55% according to the Simpson method
Summary
Heart failure (HF), which corroborates with high rates of hypertension and other cardiovascular risk factors is becoming an established public health issue world-wide. Tandon et al [12] studied the correlation of aortic root motion with left ventricular diastolic function Their procedures were not suitable for the busy or less skilled physician in low- income settings, who are often faced with patients with heart failure. With the hypothesis that aortic root motion during left ventricular systole correlated with left ventricular systolic ejection fraction as reported by Unluer et al [11], the amplitude of displacement can be a surrogate of left ventricular radial and longitudinal functions These methods need to be improved, and their application in low-income settings like ours need to be verified or studied further. There is a need for simpler measurements like the amplitude of aortic root motion in systole We carried out this cross-sectional echocardiographic study with the aim of deriving a simple, rapid and more accurate estimate of ventricular function. This study was conducted to estimate the usefulness of Aortic Root Systolic Excursion (ARSE) as a simple and accurate measure to estimate Left Ventricular (LV) function
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