Effect of successful revascularization on left ventricular diastolic dysfunction in patients with aortoiliac
1Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon Division of Cardiology, Dankook University Hospital, Dankook University College of Medicine, Cheon-an, Chungchungnam-do, Republic of Korea.
Insights
Successful revascularization of aortoiliac occlusive disease (AIOD) significantly improves left ventricular diastolic dysfunction (LVDD), indicated by a reduced E/E' ratio. This finding suggests improved cardiac function following treatment for AIOD.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Echocardiography
Background:
- Aortoiliac occlusive disease (AIOD) increases left ventricular (LV) afterload due to elevated systemic vascular resistance.
- AIOD may contribute to the development or worsening of left ventricular diastolic dysfunction (LVDD).
Purpose of the Study:
- To investigate the impact of successful AIOD revascularization on LVDD.
- To determine if revascularization improves echocardiographic markers of diastolic function.
Main Methods:
- Retrospective analysis of 37 patients with AIOD undergoing successful revascularization.
- Echocardiographic assessment of diastolic function parameters, including mitral inflow velocities (E, A), early diastolic mitral annular velocity (E'), and the E/E' ratio.
- Primary endpoint: change in the mitral E/E' ratio post-revascularization.
Main Results:
- Successful revascularization significantly reduced the E/E' ratio (P=.015).
- A significant increase in A' velocity (P=.029) and a decrease in left atrial diameter (P=.014) were observed.
- No significant changes were noted in E velocity, A velocity, LAVI, E/A ratio, or E' velocity.
Conclusions:
- Successful revascularization of AIOD is associated with significant improvement in left ventricular diastolic function, as evidenced by a reduced E/E' ratio.
- The findings suggest that addressing AIOD can positively impact cardiac diastolic mechanics.
Abstract:
Aortoiliac occlusive disease (AIOD) affects the systemic vascular resistance and increases the afterload because the left ventricle (LV) must work harder to eject blood into a smaller vascular bed. This study was to determine whether successful revascularization of AIOD is associated with improvement of left ventricular diastolic dysfunction (LVDD).A total of 37 patients with AIOD (34 men and 3 women; age 65.1 ± 7.2 years) were analyzed. The primary endpoint was defined as the change in the mitral E/E' ratio.There were no significant changes in the E velocity (from 0.7 ± 0.2 to 0.7 ± 0.2 m/s, P-value = .153), A velocity (from 0.8 ± 0.2 to 0.9 ± 0.2 m/s, P-value = .169), LAVI (from 36.1 ± 18.7 to 33.9 ± 15.7 mL/m, P-value = .176), E/A ratio (from 0.9 ± 0.4 to 0.8 ± 0.2, P-value = .091), and E' velocity (from 6.5 ± 2.0 to 6.9 ± 2.1 m/s, P-value = .068). However, successful revascularization significantly reduced the E/E' ratio (from 14.1 ± 5.7 to 11.7 ± 3.3, P-value = .015). Additionally, a significant increase in the A' velocity (from 9.1 ± 1.9 to 10.0 ± 2.2 m/s, P-value = .029) and a decrease in the LA diameter (from 40.7 ± 6.4 to 38.6 ± 6.6 mm, P-value = .014) were noted.Our results show that a successful revascularization of AIOD was associated with an improved E/E' ratio.
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