Left ventricular diastolic dysfunction in chronic aortic dissection.
BACKGROUND
In chronic aortic dissection, compression of the true lumen by the expanded false lumen may be a cause of left ventricular afterload elevation, which may result in diastolic dysfunction. We compared the left ventricular diastolic function by echocardiography between those patients who had double-barrel descending aortic dissection and those who did not.


METHODS
Twelve patients (mean age, 61 +/- 12 years) with chronic type B aortic dissection were enrolled in this study. Patients in group I had double-barrel aortic dissection that had expanded the patent false lumen and narrowed the true lumen (n = 7, 58.3%), and patients in group II had a wider-caliber true lumen with a thrombosed false lumen (n = 5, 41.7%). We evaluated the left ventricular diastolic function with the transmitral flow pattern (E and A waves) with the pulsed Doppler method and flow propagation velocity (FPV) with color M-mode Doppler images, and classified its severity into grade I (abnormal relaxation), grade II (pseudonormalization) and grade III (restriction).


RESULTS
All patients in group II had grade I diastolic dysfunction, with an E/A of less than 1.0. By contrast, 4 of the 7 patients in group I had grade II diastolic dysfunction, with an FPV/E of less than 0.6 and a pseudonormalized (> 1.0) E/A ratio (p = 0.081). Consequently, the E/A ratio was higher in group I than in group II (1.16 +/- 0.39 versus 0.68 +/- 0.18; p < 0.05).


CONCLUSIONS
It is suggested that left ventricular diastolic function is severely reduced in the patients having aortic dissection with a double-barrel and narrowed true lumen.
Shingu
Yasushige
Y
Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. fwpc1650@mb.infoweb.ne.jp
Shiiya
Norihiko
N
Mikami
Taisei
T
Matsuzaki
Kenji
K
Kunihara
Takashi
T
Matsui
Yoshiro
Y
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D002908:Chronic Disease; D003971:Diastole; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000401:mortality