P.037 Increased Aortic Stiffness Alters the Left Ventricular Rotation in Patients with Non-Ischemic Dilated Cardiomyopathy

Abstract

We hypothesized that altered proximal aorta stiffness may affect left ventricular (LV) rotation in patients with non-ischemic dilated cardiomyopathy (NIDC). Therefore, we examined 34 angiographically proven NIDC patients (aged 52.6±13.9 years) and 34 healthy volunteers. The proximal aorta (AO) pulse wave velocity (PWV) was assessed by echocardiography. The LV diastolic function was evaluated by pulsed-wave Doppler while tissue Doppler (TDI) velocities from the septal and the base lateral wall were obtained. The cardiac rotation and rotation rate were evaluated by speckle echocardiography (EchoPac, GE). Rotation and rotation rate were calculated as the average angular displacement of 6 myocardial regions (anterior, anteroseptal, lateral, posterior, inferior and septal).

Patients had increased PWV (6.7± 2.1 vs. 5.2±1.4m/s, p = 0.01) and decreased systolic cardiac rotation (–2.6 ±2.5 vs. –4.7±1.7º, p = 0.01) compared to controls. Patients had decreased systolic rotation rate (–38.6±8.7 vs. –51.7±22.3º/s, p = 0.04), early (28.1±20 vs. 49.9±35.2º/s, p = 0.01) and late (24.9±13.2 vs. 39.7±10.8º/s, p =0.002) diastolic untwisting rate compared to controls. LV ejection fraction showed no correlation with the LV rotation and rotation rate in patients. PWV was correlated with E’ (mean TDI velocity of the septal and the lateral wall) ratio, with the segmental and averaged systolic (r = –0.52, p = 0.001) and the early diastolic (r = 0.027, p = 0.05) rotation rate in patients.

We conclude that NIDC patients had increased aorta stiffness which impaired the systolic LV rotation movement affecting thus the LV systolic and diastolic function. Destiffening therapeutic interventions may be beneficial in these patients.