Abstract 5816: Lumen Augmentation Induced by Lipid Lowering Therapy is Associated with Greater Regional Left Ventricular Function by Speckle Tracking Echocardiography
Introduction: Aortic magnetic resonance imaging (MRI) can monitor plaque regression and lumen augmentation in patients undergoing treatment for advanced atherosclerosis. However, the relationship of reduced aortic plaque burden to regional left ventricular (LV) function is unknown.
Methods: 71 patients (54 males) > 65 years of age underwent MRI measurements of descending aortic lumen and plaque size obtained from axial images of the thoracic aorta by 1.5 T MRI at baseline and after 18 months of lipid lowering therapy, using T1-weighted images (after 0.1 mmol/kg of intravenous gadodiamide). All participants underwent speckle tracking echocardiography (STE) to evaluate regional LV function at 18 months.
Results: 35 patients (26 male, 35%) had an increase in aortic lumen diameter (atherosclerotic plaque burden decreased) after 18 months. These patients had greater regional LV function compared to patients who had reduction of the aortic luminal diameter (circumferential strain ECC antero septal=−21.9 and −16.6%, septum=−18.6 and −13.6, global Ecc= −16.4 and −12.5%, respectively, p<0.05). Figure 1⇓. Moreover, patients (n=13) who had disease progression characterized by decreased lumen and plaque size augmentation (vessel wall increase) presented with lesser regional function particularly in the posterior wall: Ecc =−17,2 vs −21.6%, p=0.01) Conclusions: Increased diameter of the aortic lumen is associated with increased regional ventricular function in men as assessed by speckle tracking strain Ecc. Ongoing studies investigate the role of STE in monitoring myocardial function during lipid lowering therapy in patients with advanced cardiovascular disease.