title: Assessment of cyclic changes in the diameter of the aortic annulus using speckle-tracking trans-esophageal echocardiography.
abstract: It is uncertain whether dynamic variation in the diameter of the aortic annulus occurs during the cardiac cycle in humans. The purpose of this study was to analyze cyclic changes of the aortic annulus using speckle-tracking trans-esophageal echocardiography. The subjects were 40 patients with aortic stenosis and 40 controls. Absolute and relative changes in the diameter of the aortic annulus and the times at which the maximum and minimum diameters occurred during the cardiac cycle were determined using speckle-tracking trans-esophageal echocardiography. The maximum and minimum diameters were 22.9 ± 2.7 and 20.0 ± 2.9 mm, respectively, in controls. The change in diameter of the aortic annulus was 2.9 ± 0.7 mm, and the relative change was 12.9 ± 3.5%. The maximum aortic annulus diameter was reached at the onset of aortic valve opening, and the minimum diameter occurred in the rapid filling phase. The change in diameter of the aortic annulus was significantly smaller (2.2 ± 0.6 mm vs. 2.9 ± 0.7 mm, p < 0.0001), and the time to reach the maximum diameter was significantly longer (98.5 ± 17.5 ms vs. 83.4 ± 18.2 ms, p = 0.0004), in the aortic stenosis group than in the control group. The study found that dynamic changes of the aortic annulus occur in the cardiac cycle and can be measured using speckle-tracking trans-esophageal echocardiography. We also found that aortic stenosis has an effect on the extent and timing of these changes. This suggests that accurate assessment of aortic annulus diameter requires consideration of the timing of the cardiac cycle.
authors: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. Electronic address: hisao_yskw@yahoo.co.jp.
authors: Hisao
authors: H
authors: Yoshikawa
authors: Makoto
authors: M
authors: Suzuki
authors: Go
authors: G
authors: Hashimoto
authors: Yukiko
authors: Y
authors: Kusunose
authors: Takenori
authors: T
authors: Otsuka
authors: Hidehiko
authors: H
authors: Hara
authors: Mahito
authors: M
authors: Noro
authors: Masato
authors: M
authors: Nakamura
authors: Kaoru
authors: K
authors: Sugi
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Aortic annulus diameter; Aortic stenosis; Cardiac phase; Speckle-tracking trans-esophageal echocardiography