Ultrasonic research on the correlation between aortomitral angle and left ventricular systolic function in the patients with ischemic cardiomyopathy

Objective To evaluate the relationship between the change of the aortomitral angle (AMA) with left ventricular systolic function in patients with ischemic cardiomyopathy (ICM) by echocardiography. Methods Thirty-one patients were enrolled in the ICM group, and 59 healthy subjects were selected as the control group. On the parasternal left ventricular long axis plane, AMA were measured at the R wave apex (R-AMA), J-point(J-AMA), ST-segment midpoint(ST-AMA), T-final wave (T-AMA) and P-final wave (P-AMA). The angle difference(⊿θ)=AMAmax-AMAmin, the angle changing rate =⊿θ/AMAmax. The global left ventricular longitudinal strain (GLS) and global circumferential strain (GCS) were obtained by 2D-speckle tracking echocardiography. Left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume(LVEDV) and left ventricular end-systolic volume(LVESV) were measured using Simpson biplane method. Results The J-AMA was the largest in the control group, while the ST-AMA was the largest in the ICM group. The levels of LVEDV, LVESV and AMA in ICM group were significantly higher than those in control group, while LVEF, GLS, GCS, ⊿θ/AMAmax and ⊿θ were decreased (P<0.05). In the control group, there was a correlation between T-AMA and LVEF (r=-0.349, P=0.007), and ⊿θ was negatively correlated with GLS (r=-0.372, P=0.004). In the ICM group, ⊿θ/AMAmax and ⊿θ were correlated with LVEF (r=0.424, P=0.018; r=0.490, P=0.005). Conclusions AMA in ICM patients is significantly increased. The angle difference and the rate of its change are closely related to the LVEF, which is a manifestation of three-dimensional structure change of the myocardial.