Decreased aorto‐septal angle may contribute to left ventricular diastolic dysfunction in healthy subjects

Okada, Kazunori; Mikami, Taisei; Kaga, Sanae; Nakabachi, Masahiro; Abe, Ayumi; Yokoyama, Shinobu; Nishino, Hisao; Nishida, Mutsumi; Shimizu, Chisato; Iwano, Hiroyuki; Yamada, Satoshi; Tsutsui, Hiroyuki

doi:10.1002/jcu.22126

Cited by 8 publications

(10 citation statements)

References 42 publications

(76 reference statements)

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“…A change in LV shape associated with a decrease in the ASA has been observed in healthy older subjects, which we confirmed in our study . Some have argued that this finding is related to diastolic dysfunction; in a study of 77 subjects (mean age 43 ± 14 years, 42 men), Okada and co‐workers showed that ASA significantly correlated with E ( r = 0.54, P < 0.001), isovolumic relaxation time (IRT) ( r = −0.41, P < 0.001), e′ ( r = 0.57, P < 0.01), and peak early‐diastolic myocardial global strain rate ( r = 0.63, P < 0.001) and hypothesized that reduced ASA may be related to LV diastolic dysfunction . Our data support the notion that decreased ASA is part of the presbycardia phenotype, which includes diastolic dysfunction, but we do not suggest that there is necessarily a causal relationship.…”

Section: Discussionsupporting

confidence: 89%

“…10,11 Some have argued that this finding is related to diastolic (r = −0.41, P < 0.001), e′ (r = 0.57, P < 0.01), and peak early-diastolic myocardial global strain rate (r = 0.63, P < 0.001) and hypothesized that reduced ASA may be related to LV diastolic dysfunction. 16 Our data support the notion that decreased ASA is part of the presbycardia phenotype, which includes diastolic dysfunction, but we do not suggest that there is necessarily a causal relationship.…”

Section: Septal Angulationsupporting

confidence: 53%

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The presbycardia phenotype: Cardiac remodeling and valvular degeneration in nonagenarians

et al. 2018

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Background Nonagenarians (NON) are a growing segment of the population and have a high prevalence of cardiac disease. Many findings encountered on their echocardiograms are also found in younger individuals with valvular or myocardial disease. Therefore, the purpose of this study was to describe this distinct echocardiographic phenotype. Methods We identified our study population by querying our echo database to identify unique septuagenarians (SEPT) and nonagenarians (NON) who underwent a transthoracic echocardiogram (TTE) from January 1, 2010 to December 31, 2014. Exclusion criteria were LVEF < 50%, any akinetic wall segment, aortic stenosis, moderate‐severe AR and/or severe MR, coronary revascularization within 60 days of study echo, and prior valve surgery. Results The mean age of SEPT was 73.0 ± 2.0 and NON was 92.0 ± 2.1 (P < 0.001). There was no gender difference between groups. NON had significantly smaller LV end‐diastolic diameters than SEPT (41.6 ± 5.7 mm vs 48.0 ± 7.0 mm, P < 0.001). NON had a greater relative wall thickness (0.51 ± 0.10 vs 0.40 ± 0.08, P < 0.001) and more frequently had concentric remodeling or hypertrophy. NON had higher E/Ea ratios and estimated LA pressures (P < 0.01). 48% of NON had moderate‐severe mitral annular calcification compared to 25.0% of SEPT (P < 0.01). Conclusions Herein, we provide the first comprehensive echocardiographic description of ‘presbycardia'; concentric LVH, asymmetric septal hypertrophy, mitral and aortic valve calcification, and increased epicardial fat thickness. This pattern of findings may be increasingly seen as the population ages.

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Section: Discussionsupporting

confidence: 89%

Section: Septal Angulationsupporting

confidence: 53%

The presbycardia phenotype: Cardiac remodeling and valvular degeneration in nonagenarians

et al. 2018

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“…A sigmoid septum (also denoted as ventricular septal bulge or angled aorta) is considered a normal variant or a minor abnormality often encountered in echocardiographic examinations of the elderly [12][13][14][15]23]. Sometimes, distinguishing between the SS and hypertrophic cardiomyopathy can be problematic because SS can cause an LV outflow tract obstruction [24][25][26][27][28].…”

Section: Impact Of Sigmoid Septum On Rv Shapementioning

confidence: 99%

“…Sometimes, distinguishing between the SS and hypertrophic cardiomyopathy can be problematic because SS can cause an LV outflow tract obstruction [24][25][26][27][28]. It has been also reported that subjects with SS more frequently have hypertension, greater relative wall thickness, and LV diastolic dysfunction [15,23,30].…”

Section: Impact Of Sigmoid Septum On Rv Shapementioning

confidence: 99%

“…Sigmoid-shaped ventricular septum (SS), a frequently encountered minor abnormality in echocardiographic examinations of the elderly [12][13][14][15], may alter not only left ventricular (LV) shape but also RV shape. In the present study, we aimed to determine the influence of SS on the accuracy of the 6 RV linear diameter measurements as well as the RV end-diastolic area, which was also introduced in the ASE/EACVI guidelines, in the light of three-dimensional echocardiographic (3DE) RV volume.…”

Section: Introductionmentioning

confidence: 99%

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Right ventricular basal inflow and outflow tract diameters overestimate right ventricular size in subjects with sigmoid-shaped interventricular septum: a study using three-dimensional echocardiography

Okada

Kaga

Tsujita

et al. 2019

Int J Cardiovasc Imaging

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Purpose: Sigmoid-shaped ventricular septum (SS), a frequently encountered minor abnormality in echocardiographic examinations of the elderly, may have some influence on RV shape. We aimed to determine the influence of SS on the accuracy of the 6 RV linear diameter measurements in the light of three-dimensional echocardiographic (3DE) RV volume. Subjects and Methods: The aorto-septal angle (ASA) was measured in the parasternal long-axis view using two-dimensional echocardiography (2DE) as an index of SS in 70 patients without major cardiac abnormalities who were subdivided into 35 with SS (ASA ≤120 degree) and 35 without SS (NSS). We measured RV end-diastolic volume (RVEDV) using 3DE; in addition, using 2DE, we measured basal RV diameter, mid-cavity diameter, longitudinal diameter and end-diastolic area in the apical four-chamber view; proximal RV outflow tract (RVOT) diameter in the parasternal long-axis view; and proximal and distal RVOT diameters in the parasternal short-axis view. Results: RVEDV did not differ between the SS and NSS groups. The SS group had greater basal RV diameter and proximal and distal RVOT diameters than the NSS group. RV mid-cavity diameter, longitudinal diameter, and end-diastolic area did not differ between the groups. Among the 2DE parameters of RV size, RV end-diastolic area was most strongly correlated with RVEDV (r=0.67), followed by RV mid-cavity diameter (r=0.58). Conclusion: When SS is present, the echocardiographic basal RV diameter and RVOT diameters overestimate RV size, and the measurement of RV end-diastolic area and mid-cavity diameter more correctly reflect 3D RV volume.

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Optimal left ventricular diameter measurement in subjects with sigmoid septum: comparison with three-dimensional left ventricular volume

Okada,

Nakabachi,

Hayashi

et al. 2023

J Echocardiogr

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Decreased aorto‐septal angle may contribute to left ventricular diastolic dysfunction in healthy subjects

Abstract: Background: Left ventricular (LV) diastolic dysfunction is often observed in

Cited by 8 publications

References 42 publications

The presbycardia phenotype: Cardiac remodeling and valvular degeneration in nonagenarians

The presbycardia phenotype: Cardiac remodeling and valvular degeneration in nonagenarians

Right ventricular basal inflow and outflow tract diameters overestimate right ventricular size in subjects with sigmoid-shaped interventricular septum: a study using three-dimensional echocardiography

Optimal left ventricular diameter measurement in subjects with sigmoid septum: comparison with three-dimensional left ventricular volume

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