Longitudinal change, gender difference and hemodynamic implications of aortoseptal angle in adults without structural heart diseases

Highlights

• Aging, male and sigmoid IVS were independent predictors of a steep AoSA.

• Females undergo more dramatic decrease after 70 years old.

• Electrocardiographic QRS axis left deviation tends to be correlated with a steeper AoSA.

• In adults without structural heart disease, no clinically significant association between AoSA and aortic velocity was found.

Abstract

This is an era of function evaluation for heart, but still there are some structural changes remains to be recognized. Aorto-septal angle (AoSA) is a morphologic description of the heart and adjacent major vessel. Previous studies have shown its potential hemodynamic significance, however, these are conducted in patients with structural heart diseases. The present study investigated its longitudinal change in 140 adults without structural heart disease from 20 to 90 years old and its independent clinical correlates. The findings included: 1. Advanced age, male and presence of sigmoid IVS were independent predictors of a steep AoSA. 2. Females tend to have a wider AoSA compared to age-matched males before 70 years old but they undergo more dramatic decrease with aging so that no gender difference was found beyond 70 years old. 3. Electrocardiographic QRS axis left deviation tends to be correlated with a steeper AoSA. 4. In adults without structural heart disease, no clinically significant association between AoSA and aortic velocity was found. Further prospective study from multi-centers is needed to verify these findings.