Echocardiographic aortic root motion in ventricular volume overload and the effect of mitral incompetence

Echocardiographic aortic root motion in systole was studied in 57 patients: 13 normal subjects, 4 patients with left ventricular (LV) volume overload due to anaemia, 16 patients with mitral incompetence, 13 with aortic incompetence and 11 with mitral stenosis. In normal subjects, patients with mitral stenosis and in patients with LV volume overload, in whom the increased stroke volume was ejected forwards into the ascending aorta (anaemia, aortic incompetence) the amplitude of motion of the posterior aortic wall (v(p)), the aortic widening fraction (AWF) and total aortic motion (TAM) were increased. In mitral incompetence, however, despite the large increase in total LV stroke index, there was a decrease in v(p) (P < 0.01), AWF (P < 0.001) and TAM (P < 0.001), and the decrease in aortic motion for a given stroke index was related to the mitral regurgitant fraction, indicating that aortic wall movement in systole depended predominantly on forward ejection of the LV stroke volume. Reduced echocardiographic aortic root motion and widening during systole are useful echocardiographic signs of mitral regurgitation.