الفهرس 
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Abstract
Survival is markedly shortened in patients with heart failure, which accounts for a substantial portion of all deaths from cardiovascular diseases (Corbett et al., 2003). Several indirect signs of left ventricular systolic dysfunction can be noted on m-mode echocardiography.
(Figenbaum et al., 2005).
Two D echocardiography has several disadvantages:
Accuracy may be limited by geometric assumption regarding the shape of the left ventricular cavity, it requires an experienced echocardiographer, a variety of artifacts can be generated by improper positioning of the imaging transducer or incorrect setting of the equipments gain controls.
Although qualitative assessment, such methods are time consuming and rely on assumptions regarding the left ventricle shape.
The diagnostic value of echocardiography is limited in patients with poor acoustic windows; such as obese individuals, patients with hyperinflated lungs, patients with musculoskeletal deformities (Corbett et al., 2003).
It was observed that during systole, the aortic root moves anteriorly, the height of anterior aortic motion during systole on m-mode echocardiography may be of value in the assessment of left ventricular systolic function.
The aim of this study is to evaluate the systolic function of the left ventricle by the anterior aortic wall motion obtained from M-mode parasternal long axis view ”Aorta –left atrium” in cardiomyopathic patient before and after optimal medical treatment .
To verify this aim, forty patients with echocardiographic evidence of impaired left ventricular systolic function were examined routinely before and after optimal medical treatment . Patients with more than moderate valvular diseases, aortic aneurysm and aortic dissection, previous thoracic surgery, cardiac tamponade,and congenital anomalies of the big vessels were excluded from the study.
Patients included in the study were subjected to careful history taking and thorough physical examination. Full echo-Doppler study for measurement of the LV dimensions, LVEF%, FS%, aortic root diameter, left atrial diameter and height of the anterior aortic motion obtained from long axis parasternal view (AO-LA) by M-mode echo guided by 2D echo, and calculated as a line between two points: from the heighest point of anterior motion of aortic root to the lower most point of it in millimeters.
The results of the current study showed that there was significant difference regarding the sex distribution, smoking, family history and IHD (P>0.05).
Results of the current study showed that there was no significant difference regarding the blood pressure, DM, thyrotoxicosis and COPD (P<0.05).
Results of the current study regarding the echocardiographic parameters measured showed that there was significant difference between the two groups regarding EDD, ESD, , EF, FS,and Aortic height (P< 0.005).
The height of the aortic motion was significantly lower in patients with heart failure pre optimal medical treatment as it was( 0.693 + 0.112) but it became (0.752+ 0.148 )after optimal medical treatment (P < 0.005).
In patients with heart failure there was significant positive correlation between height of the aortic motion and FS%, EF% (r = 0.482 and 0.479 respectively) and there was no significant correlation between the height of the aortic There w motion and aortic root diameter, systolic and diastolic blood pressure
(P > 0.005)