Is There a Relationship Between Aortic Valve Annular Plane Systolic Excursion and Left Ventricular Rotational Mechanics in Healthy Adults? Insights from the MAGYAR-Healthy Study
TL;DR
There are no significant correlations between AAPSE and LV rotational parameters, but the trends observed in subgroup analyses could serve as hypothesis-generating observations for future studies.
Abstract
Background/Objectives: During the cardiac cycle, the left ventricle (LV) exhibits not only a complex contraction–relaxation pattern, but also a wringing-like motion known as LV twist or rotational mechanics. Concurrently, the aortic valve and its annulus (AVA), representing the LV outlet, undergo spatial displacement throughout the cycle, which can be quantified as AVA plane systolic excursion (AAPSE). While three-dimensional speckle-tracking echocardiography (3DSTE) enables the simultaneous assessment of these functional parameters, the relationship between AAPSE and basal/apical LV rotation—particularly across different ranges of these values—remains poorly characterized in healthy subjects. Therefore, the present study aimed to characterize this relationship in detail. Methods: This study included 110 apparently healthy adult volunteers (mean age: 35.1 ± 11.9 years; 68 males). All subjects underwent two-dimensional Doppler echocardiography and 3DSTE, with the latter enabling simultaneous quantification of LV rotational parameters and AAPSE. Results: A tendency toward increased basal LV rotation and decreased apical LV rotation was observed in healthy subjects with mean AAPSE, while LV twist remained preserved compared to those with lower- or higher-than-mean AAPSE. AAPSE tended to be higher in healthy subjects with mean basal LV rotation compared with those with lower- or higher-than-mean values. Furthermore, AAPSE was significantly increased in subjects with elevated apical LV rotation. AAPSE did not correlate with any LV rotational parameters, including basal LV rotation (r = −0.008, p = 0.932), apical LV rotation (r = 0.065, p = 0.593), LV twist (r = 0.061, p = 0.632), and LV twist time (r = 0.181, p = 0.073). Conclusions: There are no significant correlations between AAPSE and LV rotational parameters, but the trends observed in subgroup analyses could serve as hypothesis-generating observations for future studies.