No abstract

Echocardiographic recording of the atrioventricular (AV) plane displacement during the cardiac cycle was used to assess left ventricular (LV) global function in patients with congestive heart failure (CHF). The study population consisted of 70 patients with chronic CHF (NYHA functional groups III and IV) following dilated cardiomyopathy (DCM) or myocardial infarction (MI), and 35 age-matched healthy subjects. The AV plane displacement was recorded from the apical 4- and 2-chamber views at four LV sites located about 90 degrees apart and representing the septal, anterior, lateral and posterior parts of the LV wall. A mean value was calculated from the above sites (AV-mean). Patients with CHF showed a significant generalized reduction of AV plane displacement compared to healthy subjects (5.6 mm vs. 14.5 mm, P less than 0.001). Thirty CHF patients also underwent radionuclide angiography in order to determine the ejection fraction (EF). The correlation between AV-mean and EF was good (r = 0.82, P less than 0.001). The selection of an AV-mean of less than 7 mm to define a severely depressed LV function (EF less than 30%) gave a sensitivity of 92% and a specificity of 67%. It is concluded that the AV plane displacement can be used to estimate LV systolic function in patients with CHF.

Abstract. A method of measuring the displacement of the atrioventricular (AV) of the left ventricle plane during the cardiac cycle in 71 healthy persons is described. An echocardiographic equipment with two cursors was used. Measurements were performed from four sites in the AV plane situated about 90 degrees apart and corresponding to the septal, anterior, lateral and posterior myocardial walls. The mean displacement during systole was 16 mm towards the apex. There was no significant difference in the recordings from the four sites. The study population was divided into three groups with mean ages 28, 42 and 60 years (group I, II and III). The displacement was significantly smaller in group III compared with groups I and II. Fractional shortening, however, could not demonstrate such a difference. The determination of displacement of the AV plane may imply the introduction of a new and simple method in assessment of left ventricular function.

The atrioventricular (AV) plane displacement was studied by echocardiography in 79 subjects (45 healthy subjects and 34 patients with acute myocardial infarction or chronic congestive heart failure). From apical 4- and 2-chamber views the displacement of the AV plane towards the apex in systole was recorded at 4 sites in the left ventricle (LV) corresponding to the septal, anterior, lateral, and posterior walls and the mean value from the above 4 sites (AV-mean) was calculated. In addition, in healthy subjects, the AV plane displacement at right ventricular free wall was also recorded. The AV-mean correlated well with the echocardiographic ejection fraction determined by biplane area-length method (r = 0.96, P less than 0.001). The correlation was also high when the percentage of the left ventricular shortening along the long axis was used (r = 0.97, P less than 0.001). The correlation between ejection fraction and AV-mean was also good when separate analysis was made for the subjects with preserved ejection fraction (r = 0.86, P less than 0.001) and decreased ejection fraction (r = 0.82, P less than 0.001). The right ventricle had a significantly higher AV plane displacement (P less than 0.001) than the LV. The study also includes determination of the muscular excursions of the septal and posterior walls along the short axis of the left ventricle from the parasternal long axis view. The AV plane displacement of the respective walls was relatively greater (P less than 0.001) compared to concentric contractions. The septal and posterior wall excursions along the short axis correlated poorly with the AV plane displacement of the respective walls (r = 0.55, P less than 0.01 and r = 42, P less than 0.05).