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Impact of aortic atheroma and distensibility on diastolic function and prognosis in patients with ischemic stroke

Dae-Young Kim1, In-Soo Kim2, Yo Han Jung3

  • 1Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Seoul, Republic of Korea.

Reviews in Cardiovascular Medicine
|January 29, 2022
PubMed

Insights

Aortic atheroma, a marker of arterial stiffness, is linked to impaired left ventricular diastolic function, particularly in women. This finding highlights a potential risk factor for heart failure with preserved ejection fraction (HFpEF).

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Nephrology

Background:

  • Ischemic stroke patients often develop heart failure with preserved ejection fraction (HFpEF) due to shared risk factors.
  • Aortic atheroma evaluation is crucial for identifying embolism sources.
  • The link between aortic atheroma severity and left ventricular (LV) diastolic function remains under-investigated.

Purpose of the Study:

  • To investigate the relationship between aortic atheroma grade and LV diastolic function in ischemic stroke patients.
  • To explore the association between aortic atheroma, aortic stiffness, and diastolic function indexes.

Main Methods:

  • Transesophageal and transthoracic echocardiography data from 295 ischemic stroke patients were analyzed.
  • Exclusion criteria included prior coronary artery disease, moderate-to-severe valvular heart disease, and LV ejection fraction < 50%.
  • Statistical analysis assessed correlations between atheroma grade, aortic stiffness, and diastolic functional indexes.

Main Results:

  • Atheroma grade correlated with aortic stiffness, E/e', left atrial volume index, and LV diastolic elastance.
  • These correlations were attenuated after adjusting for clinical factors.
  • Atheroma grade independently predicted E/e' in women but not in men, and was not linked to clinical outcomes.

Conclusions:

  • Aortic atheroma grade is significantly related to LV diastolic function, especially in women.
  • Aortic atheroma may serve as an indicator of arterial stiffness.
  • This suggests aortic atheroma could be a risk factor for HFpEF via ventricular-vascular interactions, particularly in women.
Abstract

Keywords:
Aortic atheromaDiastolic functionIschemic strokePrognosis

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