الفهرس 
Anatomy of aortic rootOnly 14 pages are availabe for public view
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Abstract
Survival is markedly shortened in patients with heart failure, which accounts for a substantial portion of all deaths from cardiovascular diseases(Corbett et al., 2003). Several indirect signs of left ventricular systolic dysfunction can be noted on m-mode echocardiography(Figenbaum et al., 2005).
2D echocardiography has several disadvantages:
Accuracy may be limited by geometric assumption regarding the shape of the left ventricular cavity, it requires an experienced sonographer and echocardiographer, a variety of artifacts can be generated by improper positioning of the imaging transducer or incorrect setting of the equipments gain controls.
Although qualitative assessment, such methods are time consuming and rely on assumptions regarding the left ventricle shape.
The diagnostic value of echocardiography is limited in patients with poor acoustic windows; such as obese individuals, patients with hyperinflated lungs, patients with musculoskeletal deformities(Corbett et al., 2003).
It was observed that during systole, the aortic root moves anteriorly, the height of anterior aortic motion during systole on m-mode echocardiography may be of value in the assessment of left ventricular systolic function.
The aim of this study was to evaluate the systolic function of the left ventricle by the anterior aortic motion obtained from m-mode –parasternal long axis view ”Aorta –left atrium”.
To verify this aim, fifty patients with echocardiographic evidence of impaired left ventricular systolic function were examined at Ain Shams Unversity and National Heart Institute from August 2007 to December 2008 and fifty subjects, age and sex matched as a control group. Patients with significant valvular diseases, aortic aneurysm and aortic dissection, previous thoracic surgery, cardiac tamponade,and congenital anomalies of the big vessels were excluded from the study.
Patients included in the study were subjected to careful history taking and thorough physical examination. Full echo-Doppler study for measurement of the LV dimensions, LVEF%, FS%, aortic root diameter, left atrial diameter and height of the anterior aortic motion obtained from long axis parasternal view (AO-LA) by M-mode echo guided by 2D echo, and calculated as a line between two points: from the heighest point of anterior motion of aortic root to the lower most point of it in millimeters.
The results show that the mean age of the patients with heart failure was significantly higher than that of the control (P< 0.005). The systolic blood pressure was significantly higher in patients heart failure than the controls (P< 0.05). The pulse pressure was significantly higher in patients with heart failure than the controls (P< 0.05). Results of the current study regarding the echocardiographic parameters measured showed that there was significant difference between the two groups regarding EDD, ESD, IVS, PWT, EF, FS,and LAD (P< 0.005).
The height of the aortic motion was significantly lower in patients with heart failure than the controls as it was 0.7 ± 0.1 for the HF patients vs 1.4 ± 0.1 for the controls (P < 0.005).
It was found that in group Ia; patients have a lower fraction shortening, a lower ejection fraction, and electrocardiographic changes in the form of poor R wave progression, wide QRS, and non specific T wave changes which indicate a more severe LV dysfunction.
In patients with heart failure (group I), there was significant positive correlation between height of the aortic motion and FS%, EF% and pulse pressure (r = 0.482, 0.479 and -0.284 respectively). There was no significant correlation between the height of the aortic motion and aortic root diameter, systolic and diastolic blood pressure (P > 0.005)
In the control group (group II), there was significant positive correlation between height of the aortic motion and EF% (r = 0.317, P < 0.05). There was significant negative correlation between the height of the aortic motion and age of the patient (r = -0.559, P < 0.05). There was no significant correlation between the height of the aortic motion and aortic root diameter, fraction shortening, systolic and diastolic blood pressures (P > 0.05).