Heterogeneity of left ventricular wall dynamics in normal hearts and in chronic aortic regurgitation. A two-dimensional echocardiographic study.

The variation in shape, in the global and regional function of the left ventricle (LV) was quantitated by using Two-Dimensional Echocardiography (TDE) in 20 normal subjects (N) (17 males, 3 females, with a mean age of 21.2 years, age range 15 to 34) and compared to 20 patients with aortic regurgitation (AR) (14 males, 6 females with a mean age of 31 years, age range 16 to 51). The left ventricle was subdivided into two TDE short axis cross-sections at the papillary muscle (PM) and at the mitral valve (MV) level. Wall motion was assessed by the following indices; endocardial systolic fractional area change (FAC), wall thickening (Wth) and circumferential fiber shortening (S). The ejection fraction (EF), the diastolic (EID) and systolic eccentricity index (EIS), the end-diastolic volume (EDV), the end systolic volume (ESV) and the LV mass (M) were estimated using a 4 chamber apical view. Measurements of sectional cavity areas, muscle areas and endocardial perimeters were obtained twice independently by two observers using a computer aided system, to achieve the final results as the mean of the 4 measurements. Paired t-test showed a statistically significant variation between PM and MV for FAC in N (p less than 0.001). A statistically significant difference (p less than 0.01) was found for EID between N and AR. The EIS was not significantly different in the two groups. In AR a significant difference was found between EID and EIS (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)