Systolic Aortic Root Motion and Angle as novel indices of Left Ventricular Systolic Function

Background Aortic root motion was used only as a surrogate parameter of global left ventricular systolic function depending on its direct proportion to cardiac output. We hypothesize that aortic root motion angle and aortic root motion amplitude may overcome many limitations of EF calculation by M mode and two dimensional methods and are easier and reproducible.Objective The aim of this study is to asses systolic aortic root motion measured by M mode and aortic root motion angle as novel indices of global left ventricular systolic function.Patients and methods one hundred patients were enrolled in this study and divided into four groups: according to their age (above and below 60 years) and EF (above and below50%). They were subjected to full history taking, careful clinical examination, and conventional echo-Doppler study .Systolic aortic root motion obtained from long axis parasternal view by M-mode echo guided by 2D echo, and aortic root motion angle was traced off line and mathematically measured. Also global logitudinal strain (GLS) and global longitudinal strain rate (GLSR) from apical 4,3 and 2 chamber views were measured offline.Results Statistical analysis of collected data show that there are significant differences between control groups and patient groups in aortic root motion angle (t= 16.9 and p value <0.001, and in aortic root motion amplitude (t= 20.1 and p value <0.001). Aortic root motion (cm) and aortic root motion angle have significant positive correlation with EF(Mm), EF(2D), Fs, global longitudinal strain(GLS) and global Strain rate . The best cutoff value of aortic root motion angle was 19.5 degree, with sensitivity of 93.9%, specificity of 96.1.Aortic root motion angle >19.5 predicts systolic function >50% and that<19.5 predicts systolic function <50% The best cutoff value of aortic root SAM was 8.5 mm. An aortic root SAM of ˂ 8.5 mm predicts an LVEF of ˂ 50% with sensitivity of 95.9%, specificity of 96.1%.Conclusion The amplitude of systolic aortic root motion (SARM) by (M-mode) and aortic root motion angle are well- correlated with the EF and GLS and could be considered as novel indices of global left ventricular systolic function with high accuracy and reproducibility .