A greater end-diastolic AVA area was associated with significantly reduced basal LV radial strain (29.1% vs 34.3%, p<0.05) and longitudinal strain compared to a greater end-systolic AVA area.
Cross-Sectional (n=112)
Are there differences in left ventricular mechanics in healthy adults based on whether the end-diastolic or end-systolic aortic valve annulus area is larger?
Healthy adults with a greater end-diastolic aortic valve annulus area exhibit reduced basal radial and longitudinal LV strains and lower basal LV rotation compared to those with a greater end-systolic area.
Absolute Event Rate: 29.1% vs 34.3%
p-value: p=<0.05
Abstract Introduction According to the literature, in approximately 60% of cases, aortic valve annulus (AVA) is greater in end-systole, equal with end-diastolic value in 8% and larger in end-diastole in 32% of healthy subjects. However, it is unclear whether any left ventricular (LV) functional differences may be behind this phenomenon. Therefore, the aim of the present study was to investigate the potential LV volumetric and functional differences observed in healthy individuals based on whether the end-diastolic or end-systolic AVA area is larger. Methods The present study comprised 112 healthy adults who underwent two-dimensional (2D) Doppler echocardiography together with 3D speckle-tracking echocardiography (3DSTE). Three subgroups were created, in which end-systolic AVA area was greater (n=70), end-systolic and end-diastolic AVA areas were equal (n=8) and end-diastolc AVA area was greater (n=34). Results No differences in routine 2D echocardiographic data and 3DSTE-derived LV volumetric parameters could be detected between the groups examined. Global and mean segmental LV strain did not differ between the groups examined. However, basal LV radial (29.1 ± 9.2% vs. 34.3 ± 13.3%, p0.05) and longitudinal (-19.2 ± 3.9% vs. -20.9 ± 4.4%, p0.05) strains proved to be significantly reduced in subjects with a greater end-diastolic AVA area as compared to cases with a greater end-systolic AVA area. Subjects with equal end-diastolic and end-systolic AVA areas showed significantly reduced basal LV longitudinal strain as compared to those with greater end-systolic AVA area (-17.7 ± 3.5% vs. -20.9 ± 4.4%, p0.05). Additionally, basal LV rotation proved to be significantly lower in subjects with greater end-diastolic AVA area as compared to those with a greater end-systolic AVA area as well (-3.43 ± 1.49 degrees vs. -4.50 ± 2.33 degrees, p0.05). Conclusions Although most of healthy adults have greater end-systolic than end-diastolic AVA area, 30% of cases show greater end-diastolic AVA area. Healthy subjects with a greater end-diastolic AVA area have reduced basal radial and longitudinal LV strains, as well as lower basal LV rotation as compared to those with a greater end-systolic AVA area.
Nemes et al. (2026) conducted a cross-sectional in Healthy adults (n=112). Greater end-diastolic aortic valve annulus (AVA) area vs. Greater end-systolic AVA area was evaluated on Basal LV radial strain (p=<0.05). A greater end-diastolic AVA area was associated with significantly reduced basal LV radial strain (29.1% vs 34.3%, p<0.05) and longitudinal strain compared to a greater end-systolic AVA area.