Author + information
- Himanshu Gupta,
- Oleg F. Sharifov,
- Chun S. Schiros,
- Jose Tallaj,
- Inmaculada Aban,
- Sumanth Prabhu,
- Louis J. Dell'italia and
- Thomas Denney
Background: Characterization of early diastolic dysfunction in preserved ejection fraction (EF) remains challenging. Using a comprehensive single beat method, we evaluated left ventricular (LV) mechanical properties in this cohort.
Methods: Thirty-eight participants with LVEF ≥50% with stage B and NYHA class I-II stage C heart failure without acute infarction were studied. Invasive high fidelity pressure measurements and cardiac magnetic resonance imaging were performed to compute LV pressure-volume and stress-strain relationships using single beat method. Various systolic and diastolic mechanical parameters were obtained (Table). LV relaxation time constant, Tau >48 ms and LV end diastolic pressure (LVEDP) > 12 mmHg was considered abnormal.
Results: Mean LVEF was 64±9%. LV wall stress was increased and LV end systolic (ES) elastance was reduced in elevated LVEDP and Tau. Although there were no difference in EDV15 and ESV140 volumes using single beat method (see Table legend) or myocardial stiffness (βmyo), the chamber stiffness constant (βch) was increased (Table). All single beat parameters significantly correlated to LV volumes, with strongest correlation for EDV15 and ESV140 (r > 0.7). EDV15, ESV140 and βmyo did not correlate to LVEDP or Tau, whereas βch and ES elastance correlated to Tau.
Conclusions: There is a compensatory adaptation in mechanical indices which needs to be taken into account for evaluating early stages of heart failure/ diastolic dysfunction and designing clinical trials.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-264
- 2017 American College of Cardiology Foundation