Diastolic Aortic Root Motion in Left Ventricular Hypertrophy

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.