273 Correlation between longitudinal systolic function of the left ventricle and the “non-velocity-type” parameters characterizing left ventricular diastolic function

Abstract

It is known that patients with diastolic dysfunction have usually impaired left ventricular (LV) longitudinal systolic function, and the latter parameter shows strong correlation with the (tissue) Doppler parameters of the LV diastolic function. The role of non-velocity-type parameters of the global LV diastolic function have not been investigated yet. LV mass and left atrial volume, however, seem to be important factors as the former influences passive ventricular distension and the latter is established as a marker of the diastolic dysfunction's severity. The aim of our study was to investigate the relationship between LV longitudinaJ systolic function and these parameters. The same correlations were also investigated in patients with impaired systolic function. Patients: 16 healthy subjects, 29 patients suffering from hypertrophic cardiomyopathy (HCM) (ejection fraction >50%) and 24 patients with dilated cardiomyopathy (DCM) (EF< 35%) were studied. The three groups matched in age and gender. Inclusion criteria were: normal sinus rhythm, absence of moderate to severe mitraJ valve disease. Methods: In addition to the conventional transmitral flow patterns pulmonary vein Doppler parameters were measured by ATL HDI 5000 ultrasound system. Myocardial systolic velocity (S) was measured at the lateral border of the mitraJ annulus using tissue Doppler imaging. Ma~ximaJ left atrial volume (Vma~x) was measured from the apical 4and 2-chamber views using Simpson's method. The use of Devereux's mass index is probably limited in patients with HCM and DCM, so cardiac magnetic resonance imaging (1.5 T Siemens Vision plus) was used to determine the LV mass. LV mass and Vmax were normalized to body surface area (LVMI; Vma~x index). Results: In HCM patients isolated diastolic dysfunction while in DCM patients combined systolic and diastolic dysfunction were found. In HCM patients lateral S correlated negatively with LVMI (r= -0.492, p<0.01) and Vma~x index (r= -0.492, p<0.01). In DCM patients similar correlations were found with LVMI (r= -0.418, p<0.05) and Vma~x index (r=0.515, p<0.05), too. No significant correlation was found in the group of healthy volunteers. Conclusion: LV longitudinal systolic function showed a significant negative correlation with non-velocity-type parameters of the LV diastolic function such as LVMI and Vma~x index in patients with diastolic dysfunction and in patients with combined systolic and diastolic dysfunction as well.