Altered Aortic Hemodynamics and Relative Pressure in Patients with Dilated Cardiomyopathy

Area of Science:

• Cardiovascular Imaging and Hemodynamics
• Cardiology
• Biomedical Engineering

Background:

• Ventricular-vascular interaction is crucial in cardiovascular disease adaptation.
• Current monitoring of cardiomyopathy patients relies heavily on cardiac biomarkers.
• Aortic function assessment is underexplored in dilated cardiomyopathy (DCM).

Purpose of the Study:

• To investigate aortic function in patients with idiopathic dilated cardiomyopathy (DCM).
• To explore the relationship between ventricular function and aortic hemodynamics in DCM.
• To establish advanced imaging as a tool for understanding DCM manifestation.

Main Methods:

• Cardiac magnetic resonance imaging (CMR) was performed on 14 DCM patients and 16 controls.
• Physics-based image processing was used to derive aortic relative pressure.
• A virtual cohort was employed to analyze the impact of cardiovascular properties on aortic behavior.

Main Results:

• DCM patients with reduced left ventricular systolic function exhibited significantly lower aortic relative pressure.
• Increased aortic stiffness and delayed time-to-pressure peak duration were observed in DCM patients.
• Aortic stiffness and volumetric size were identified as primary determinants of aortic relative pressure in the virtual cohort.

Conclusions:

• Advanced flow imaging and hemodynamic evaluation offer novel insights into DCM.
• The study demonstrates altered aortic structure and function in DCM using a proposed imaging protocol.
• This approach could complement cardiac biomarkers for improved DCM monitoring and understanding.