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Association between invasively measured central aortic pressure and left ventricular diastolic function in patients
Hack-Lyoung Kim1, Jae-Bin Seo1, Woo-Young Chung1
1Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Insights
Invasive central aortic pressure parameters like pulse pressure (PP) and pulsatility index (PI) are linked to left ventricular (LV) diastolic function (e
Area of Science:
- Cardiovascular physiology
- Cardiac imaging
- Hemodynamics
Background:
- Limited understanding of left ventricular (LV) and aortic hemodynamic interactions due to invasive catheterization.
- Need for invasive aortic pressure monitoring to explore these interactions.
Purpose of the Study:
- To investigate the relationship between invasively measured central aortic pressure waveform parameters and LV diastolic function.
- To assess associations between pulse pressure (PP), fractional PP (FPP), pulsatility index (PI), and LV diastolic parameters.
Main Methods:
- Prospective evaluation of 153 stable patients undergoing invasive coronary angiography (ICA) and transthoracic echocardiography (TTE).
- Central aortic pressure waveform acquired invasively via pigtail catheter.
- Analysis of PP, FPP, PI, augmentation index, wave reflection time, and ejection duration against TTE-derived LV diastolic function parameters.
Main Results:
- Significant correlations found between PP, FPP, and PI with e' and E/e' in multiple linear regression analyses.
- These associations remained significant after adjusting for potential confounders.
- No significant correlations observed between other LV diastolic parameters (E/A, deceleration time, left atrial volume index) and central aortic pressure wave parameters.
Conclusions:
- Invasively measured central aortic PP, FPP, and PI are independently associated with e' and E/e' in patients undergoing ICA.
- Findings support a close interaction between LV diastolic function and aortic stiffness in this patient population.
- This study provides further evidence of the hemodynamic interplay between the left ventricle and aorta.
Background:
Because of the invasive nature of catheterization, limited information is available on hemodynamic interaction between the left ventricle and aorta using invasive aortic pressure monitoring. Our aim was to investigate whether parameters of invasively measured central aortic pressure waveform were related with those of left ventricular (LV) diastolic function.
Methods:
A total of 153 consecutive stable patients (mean age = 64±11 years; 62% men) undergoing invasive coronary angiography (ICA) and transthoracic echocardiography (TTE) were prospectively evaluated. Central aortic pressure waveform was obtained at the ascending aorta using a pigtail catheter before ICA. We calculated pulse pressure (PP), fractional PP (FPP; the ratio of PP to mean pressure), pulsatility index (PI; the ratio of PP to diastolic pressure), augmentation index, wave reflection time, and ejection duration and analyzed their associations with parameters of LV diastolic function in TTE.
Results:
Most patients (n = 135/153; 88.2%) had significant stenosis (≥50%) of ≥1 epicardial coronary arteries. In multiple linear regression analyses, e' and E/e' were significantly correlated with PP, FPP, and PI even after adjustment for potential confounders. There were no significant correlations between other parameters of LV diastolic function, including E/A, deceleration time, and left atrial volume index and parameters of central aortic pressure wave.
Conclusions:
Invasively measured central aortic PP, FPP, and PI were independently associated with e' and E/e' in patients undergoing ICA. This result adds to the evidence of a close interaction between LV diastolic function and aortic stiffness in this population.
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