Long axis excursion in aortic stenosis

Citation
S. Takeda et al., Long axis excursion in aortic stenosis, HEART, 86(1), 2001, pp. 52-56
Citations number
31
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
HEART
ISSN journal
13556037 → ACNP
Volume
86
Issue
1
Year of publication
2001
Pages
52 - 56
Database
ISI
SICI code
1355-6037(200107)86:1<52:LAEIAS>2.0.ZU;2-U
Abstract
Objectives-To examine long axis excursion in patients with all grades of ao rtic stenosis and preserved transverse systolic function, and to compare lo ng axis excursion in symptomatic with that in asymptomatic severe aortic st enosis. Design-Prospective comparative study. Setting-Regional cardiothoracic centre. Patients-78 patients with all grades of aortic stenosis and normal fraction al shortening and ejection fraction were studied. There were two comparison groups, 10 age matched normal subjects and 14 patients with aortic stenosi s and fractional shortening < 26%. Methods-Aortic valve function and left ventricular mass were assessed echoc ardiographically. M mode measurements of long axis excursion at the septal and lateral sides of the mitral annulus were taken. Results-There were significant differences between the groups in long axis excursion at both the septal (p < 0.0001) and lateral sides of the mitral a nnulus (p = 0.002 by analysis of variance). Long axis excursion was indepen dently related to both left ventricular mass index (p = 0.001) and the grad e of aortic stenosis (p = 0.002). Comparing patients with severe aortic ste nosis with and without symptoms, there were significant differences in effe ctive orifice area (p = 0.02) and long axis excursion at the lateral side o f the mitral annulus (p = 0.04), but not in fractional shortening, ejection fraction, or peak or mean pressure difference. Conclusion-In patients with aortic stenosis, long axis excursion is reduced even in the presence of normal fractional shortening or ejection fraction. It is lower in patients with symptomatic compared with asymptomatic severe aortic stenosis and may be of use in predicting the onset of symptoms.