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Left ventricular diastolic dysfunction in chronic aortic dissection

Yasushige Shingu1, Norihiko Shiiya, Taisei Mikami

  • 1Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. fwpc1650@mb.infoweb.ne.jp

The Annals of Thoracic Surgery
|March 27, 2007
PubMed

Insights

Chronic aortic dissection with a double-barrel aorta and narrowed true lumen significantly impairs left ventricular diastolic function. This condition leads to more severe diastolic dysfunction compared to other forms of aortic dissection.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Aortic Diseases

Background:

  • Chronic aortic dissection can elevate left ventricular afterload due to true lumen compression by an expanded false lumen.
  • This compression may lead to impaired left ventricular diastolic function.

Purpose of the Study:

  • To compare left ventricular diastolic function in patients with double-barrel descending aortic dissection versus those without.
  • To investigate the impact of true lumen narrowing on diastolic function.

Main Methods:

  • Echocardiography was used to evaluate left ventricular diastolic function in 12 patients with chronic type B aortic dissection.
  • Patients were divided into two groups: double-barrel dissection with a narrowed true lumen (n=7) and wider true lumen with thrombosed false lumen (n=5).
  • Transmitral flow patterns (E/A waves) and flow propagation velocity (FPV) were assessed and diastolic dysfunction was graded.

Main Results:

  • Patients with a narrowed true lumen (double-barrel) showed a higher E/A ratio (1.16 +/- 0.39) compared to those with a wider true lumen (0.68 +/- 0.18).
  • Four of seven patients in the double-barrel group exhibited grade II diastolic dysfunction (pseudonormalization), indicated by FPV/E < 0.6 and E/A > 1.0.
  • All patients with a wider true lumen had grade I diastolic dysfunction (abnormal relaxation) with E/A < 1.0.

Conclusions:

  • Left ventricular diastolic function is significantly reduced in patients with aortic dissection characterized by a double-barrel aorta and a narrowed true lumen.
  • True lumen compression in double-barrel aortic dissection is associated with more severe diastolic dysfunction.
Abstract

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