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Published on: February 23, 2020
Males with abdominal aortic aneurysm have reduced left ventricular systolic and diastolic function
Ida Åström Malm1, Rachel De Basso1, Jan Engvall2,3
1Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
Insights
Abdominal aortic aneurysms (AAAs) are linked to impaired left ventricular systolic and diastolic function in men. This suggests AAA may represent a broader aortic disease affecting heart function.
Area of Science:
- Cardiology
- Vascular Medicine
- Echocardiography
Background:
- Abdominal aortic aneurysm (AAA) is a known risk factor for heart failure and cardiovascular events.
- Limited understanding exists regarding left ventricular (LV) function in patients with AAA.
Purpose of the Study:
- To investigate the association between AAA and left ventricular systolic and diastolic dysfunction using echocardiography.
- To compare LV function in male patients with AAA against a control group.
Main Methods:
- Echocardiography was performed on 307 males (199 with AAA, 108 controls) between 2011-2016.
- Participants were recruited from AAA surveillance and screening programs.
Main Results:
- Subjects with AAA exhibited thicker LV walls and reduced systolic function (lower ejection fraction and global longitudinal strain).
- Diastolic dysfunction was indicated by decreased mitral annular plane systolic excursion and higher E/e' ratio in the AAA group.
- Wider aortic sinus and ascending aorta diameters were observed in AAA patients compared to controls.
Conclusions:
- Abdominal aortic aneurysms are associated with impaired left ventricular systolic and diastolic function in males.
- The findings suggest that AAA may be part of a generalized aortic disease process, impacting cardiac function.
Background:
Abdominal aortic aneurysm (AAA) increases the risk of chronic heart failure and other major cardiovascular events. Knowledge about left ventricular function in patients with AAA is lacking. This echocardiographic study aimed to investigate whether AAA is associated with left ventricular systolic and diastolic dysfunction.
Methods:
Echocardiography was performed in 307 males (199 AAA and 108 controls) recruited from a regional ultrasound surveillance programme of known AAA, or from an ongoing ultrasound screening programme, during 2011-2016.
Results:
Subjects with AAA had thicker septal and posterior walls and a reduced left ventricular function compared to controls. Left ventricular ejection fraction (AAA 55 ± 8%, controls 57 ± 7%) and global longitudinal strain (AAA 19 ± 3%, controls 20 ± 3%) were lower in the group with AAA (both p < 0·05). Moreover, decreased mitral annular plane systolic excursion (12 ± 2 mm versus 13 ± 2 mm) and higher E/e' (13 ± 5 versus 11 ± 4) were observed in subjects with AAA (both p < 0·05). The aortic sinus (38 ± 4 mm versus 35 ± 2 mm) and ascending aorta (36 ± 4 mm versus 34 ± 5 mm) were also wider in the AAA group compared to controls (both p < 0·01).
Conclusion:
AAAs are associated with reduced left ventricular systolic and diastolic function in males. The larger diameter of the aortic sinus and ascending aorta among AAA patients suggests that AAA is a general aortic disease.
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