Relationship between aortic stiffness and modes of left ventricular deformation at rest and dobutamine-stress differ in
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Relationship between aortic stiffness and modes of left ventricular deformation at rest and dobutamine-stress differ in the presence of preserved and compromised contractile capacity Valentina O Puntmann1*, Alun D Hughes2, Rolf Gebker3, Cosima Jahnke3, Jesus G Mirelis3, Bernhard Schnackenburg3, Eckart Fleck3, Frank Rademakers4, Ingo Paetsch3 From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Objective To investigate the phenotypic relationships between aortic stiffness and left ventricular (LV) stroke volume (SV) and modes of deformation (longitudinal - LD and radial -RD) at rest and stress, with preserved and compromised contractile capacity.
Background Increased aortic stiffness, measured by pulse wave velocity (PWV), is linked to a range of cardiovascular (CV) risk factors and acts as predictor of CV events, independently of age-related increase in pulse pressure. As an integrated marker of the pulsatile component of LV
Figure 1 Aortic stiffness and distensibility measurements by MRI.
1 Imperial College London/The German Heart Institute Berlin, London, UK Full list of author information is available at the end of the article
© 2011 Puntmann et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Puntmann et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P130 http://jcmr-online.com/content/13/S1/P130
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Figure 2 Measures at rest and dobutamine stress.
afterload, PWV has been linked to prognostically adverse cardiac phenotypes, including LV systolic dysfunction and post-infarct remodelling. Evidence suggests that longitudinal mode of deformation is particularly important to overcome the superimposed afterload. Thus, reduced LD due to myocardial ischaemia or scar may influence the capacity to offset the LV afterload in patients with increased aortic stiffness.
late-stage increase and reduction of LV wall stress and RD, respectively. At rest, LD was the sole predictor of PWV in all groups at rest, and also with dobutaminestress for the negative group, with late reversal into a positive relationship. In other groups, the association between PWV and total LD was negative throughout, with a differential relationship with total RD: positive in ischaemic and negative in remodelling.
Methods At total of 124 cardiac patients underwent a high-dose dobutamine-stress/perfusion magnetic resonance (DS(P) MR) protocol with simultaneous late gadolinium enhancement (LGE) imaging and aortic pulse wave velocity (PWV) measurements (Figure 1).
Conclusions Our findings reveal that modes of deformation to increased aortic stiffness differ at rest and dobutaminestress and with compromised LV contractility: intact myocardium relies on longitudinal function to displace volume and offset
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