Frljak, Sabina;
Poglajen, Gregor;
Cerar, Andraz;
Zemljic, Gregor;
Vrtovec, Bojan
Abstract 13119: Local Diastolic Dysfunction is Associated With Decreased Myocardial Viability in Patients With Heart Failure With Preserved Ejection Fraction
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Media type:
E-Article
Title:
Abstract 13119: Local Diastolic Dysfunction is Associated With Decreased Myocardial Viability in Patients With Heart Failure With Preserved Ejection Fraction
Description:
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<jats:bold>Introduction.</jats:bold>
Although impaired global diastolic function is a key determinant of heart failure with preserved ejection fraction (HFpEF), the impact of local diastolic dysfunction is less clear.
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<jats:bold>Hypothesis.</jats:bold>
We analyzed the distribution and myocardial viability correlates of local diastolic dysfunction in patients with HFpEF.
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<jats:bold>Methods.</jats:bold>
We enrolled 30 patients with HFpEF (NYHA class III, LVEF >50%, E/e' >15, and NT-proBNP >300 pg/ml) who were referred to our center for cell transplantation. Before transplantation, all patients underwent electroanatomical mapping; viable myocardium was defined as unipolar voltage (UV) ≥8.27 mV and non-viable myocardium was defined as UV <8.27 mV. Local diastolic function was assessed by a novel algorithm based on the measurement of local mechanical diastolic delay (LMD). At each sampling point, LMD was measured as timing difference between global end diastolic time (based on left ventricular volume) and maximum local diastolic time (based on local wall movement of the mapping point).
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<jats:bold>Results.</jats:bold>
Most of the patients were male (77%), with a mean age of 62±10 years, creatinine of 1.05±0.40 mg/dl, E/e’ of 18.0±3.5, and LVEF of 57.6±6.1%. Using electroanatomical mapping we generated a total of 4820 mapping points in 30 patients. The mean local mechanical diastolic delay was 47±33 msec, and the coefficient of variation was 0.70. The distribution of local mechanical diastolic delay in points with preserved myocardial viability and decreased myocardial viability is presented in Figure 1. We found a significant inverse correlation between UV and LMD (r= -0.18, P=0.001).
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<jats:bold>Conclusions.</jats:bold>
In patients with HFpEF, areas of local diastolic dysfunction are unevenly distributed and appear so correlate with areas of decreased myocardial viability.
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<jats:bold>Figure 1.</jats:bold>
Distribution of LMD in areas of decreased and preserved myocardial viability.
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<jats:graphic xmlns:xlink="http://www.w3.org/1999/xlink" orientation="portrait" position="float" xlink:href="g13119.jpg" />
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