Abstract 578: Comprehensive Diastolic Function Analysis in Patients With Preserved versus Depressed LVEF and Their Hemodynamic and Structural Determinants
Introduction: There are few data on diastolic myocardial mechanics in patients with preserved versus depressed left ventricular ejection fraction (LVEF) and their hemodynamic and structural determinants.
Methods: Patients referred for cardiac catheterization underwent comprehensive echocardiography ≤20 minutes from catheterization. Early and late diastolic longitudinal, radial, circumferential and torsional strain (S) and strain rate (SR) were measured. LVEF≥ 50% was preserved. Independent determinants of diastolic myocardial mechanics were determined using multivariate analysis.
Results: 100 patients were studied with mean age= 54.8+/−8.9 years; 44% were women, 82% hypertensive, 42% diabetic and 62% had significant angiographic coronary artery disease (CAD, ≥ 70% diameter stenosis). Multivector diastolic early and late S and SR were greater in patients with preserved, compared to depressed LVEF (Table⇓). Early longitudinal diastolic S was independently determined by LVEF and CAD (R= 0.75, p< 0.001, respectively). Radial, circumferential, and torsional early diastolic S were determined by LVEF (R= 0.62, P< 0.001; R= 0.71, p< 0.001; and R= 0.49, p< 0.001, respectively). Torsional early diastolic SR was determined by LVEF and LVEDP (R= 0.62, p= 0.008 and p= 0.04, respectively). Circumferential late diastolic S was determined by LVEF, CAD and LVEDP (R= 0.61, p< 0.001, p= 0.06 and p= 0.06, respectively) and torsional late diastolic SR was determined by CAD (p= 0.007).
Conclusions: In patients with cardiac disease, myocardial diastolic S and SR are greater in patients with preserved compared to depressed LVEF. These diastolic myocardial mechanics are determined, to varying degrees, by LVEF, CAD and LVEDP.