DOES AORTIC STIFFNESS AFFECT THE RIGHT VENTRICULAR FUNCTIONS IN PATIENTS WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION?

Abstract

Objective: To determine the effect of aortic stiffness on right ventricular (RV)diastolic and systolic functions in individuals with left ventricular diastolicdysfunction (LVDD).

Methodology: Patients aged above forty years with LVDD confirmed by transthoracicechocardiography were included in this study in Ain Shams UniversityHospitals from January 2015 to 2016.Systolic functions of the RV and LV wereassessed by two-dimensional echocardiography and pulsed wave tissueDoppler echocardiography. The diastolic diameter was obtained at the peak ofQRS complex of the single lead ECG recorded by the echo machine while thesystolic diameter was obtained at the maximum anterior motion of the aorta.Aortic distensibility (AD), aortic strain (AS) and aortic stiffness index (ASI) wereused as aortic elasticity parameters. Blood pressure was measured with amercury sphygmomanometer.

Result: A total of 300 consecutive patients were enrolled prospectively. Thisstudy showed that there were significant statistical differences between rightventricular diastolic function with all its states and aortic distensibility, aorticstrain and aortic stiffness index. Various parameters reflecting right ventricularsystolic and diastolic functions were independent predictors of AS, AD and ASI.Aortic parameters AS, AD and ASI were related to RV systolic function as therelation with TV S was 0.024, 0.002 and 0.010 respectively, also the relation withTAPSE was 0.027, 0.034 and 0.043 respectively. AS, AD and ASI were in additionrelated to RV diastolic function as seen with TV E/E' with p values 0.020, 0.020 &0.000 respectively. RV DD grade was related to AS, AD & ASI with p values 0.010,0.004 and 0.003 respectively.

Conclusion: RV systolic and diastolic parameters are independent predictors ofaortic parameters reflecting aortic stiffness. This relation needs further study toverify the relation of the aorta and right ventricle although they are not inanatomical continuity with each other.