Abstract 242: Diastolic Wall Strain Reflects the Myocardial Fibrosis in Heart Transplanted Patients
Background: Left ventricular (LV) wall stiffening plays an important role in the development of heart failure with preserved EF. We have recently reported that diastolic wall strain (DWS) significantly and inversely correlates with myocardial stiffness constant in the animal experiment, and that this relation is consistent with the linear elastic theory (Takeda, et al. J Card Fail, 2009). However, it has not been clarified what determines DWS in clinical setting.
Objective and methods: Echocardiographic and histological data were collected in 27 heart transplanted recipients. Myocardial tissues were obtained from the interventricular septum at the routine assessment of the degree of rejection, and the percent area of fibrosis (AOF) was evaluated. DWS was calculated on the echocardiogram as follows. DWS=(LV posterior wall thickness at end-systole-LV posterior wall thickness at end-diastole)/(LV posterior wall thickness at end-systole)
Results: There was an inverse correlation between DWS and AOF (R=−0.50, P=0.008). However, there was no correlation between DWS and LV ejection fraction, LV fractional shortening, LV mass index, or indices derived from the transmitral flow velocity curves.
Conclusion: This clinical study indicates that the decrease in DWS is associated with progressive LV fibrosis and suggests the clinical usefulness of DWS in assessing LV stiffening and its related histological changes.