Abstract 18719: The Morphologic and Topographic Characters of Pulmonary Vein Function in Relation to Velocity of Propagation and Diastology in Heart Failure with Preserved Ejection Fraction: A Dedicated Computed Tomography Study

Abstract

The Morphologic and Topographic Characters of Pulmonary Vein Function in Relation to Velocity of Propagation and Diastology in Heart Failure with Preserved Ejection Fraction: A Dedicated Computed Tomography Study Background Diastolic dysfunction (DD), an assumed pathophysiologic intermediate between hypertension and heart failure (HF), has traditional be evaluated by echocardiography. However, data regarding the transition from DD to diastolic HF by assessing pulmonary vein morphological and topographic descriptions utilizing high spatial resolution computed tomography (CT) had been lacking.

Materials and Methods We studies totally 124 subjects with conventional echo done and 64-slice CT performed. Of all, only 119 had data analyzable for both echo and CT methods. Sequential pulmonary veins orifice diameter and area from all four veins, both max and minimal value, during consecutive 1 R-R heart cycle were analyzed equally into 6 parts. Echo-derived left atrial and ventricular volume, high-frame rate tissue Doppler imaging (TDI), velocity of propagation (VP), estimated LV filling pressure (PCWP by E/E’) and some other diastolic indices were all obtained.

ResultsM Of all 119 subjects (43 non-DD, 44 DD, and 32 DHF) entered for our final study (age: 59.3 ± 11.2, 37% female), we observed a graded enlargement, both max and minimum value, for all 4 pulmonary vein orifices across these three groups (all trend p<0.05). In addition, linear relationship was observed between all 4 PV orifices area and echo-derived PCWP and VP (all p<0.05) value, with both left superior and inferior PV maximum area further related to serum BNP level (both p<0.05). When left superior and inferior PV maximum area were superimposed on LV mass index, PCWP and LA volume, there were significant increase in the DHF prediction model X2 value using likelihood ratio test (both p<0.05).

Conclusion Topographic PV size estimates using computed tomography rendered detailed assessment of structural and functional characters feasible, which correlated well with diastolic dysfunction. Our data suggested that CT-based PV measure may help identify subjects at risk even in a more early stage heart failure.