Left ventricular diastolic dysfunction in chronic 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.