Abstract 13852: Relationship Between LV Contractility and Coronary Flow Reserve in Non-ischemic Dilated Cardiomyopathy: A Noninvasive Stress-echo Study
Introduction: LV contractility plays an important diagnostic and prognostic role in non-ischemic dilated cardiomyopathy (IDC). Systolic pressure/end-systolic volume relationship (SP/ESVi) is a useful method for evaluating LV myocardial contractility during stress echocardiography (SE). Coronary flow reserve (CFR) on left anterior descending (LAD) can be reduced in IDC.
Hypothesis: to assess the relationship between SP/ESVi and CFR on LAD in IDC patients.
Methods: We enrolled 134 IDC patients (98 men; 62±12 years, mean value of ejection fraction: 34±8%) and 38 age-sex matched normal subjects as control’s group (29 men; 65±11 years, mean value of ejection fraction: 61±4%). All underwent dipyridamole SE (dip-SE 0.84 mg/kg in 6'). CFR was defined as the ratio between maximal vasodilation and rest peak diastolic flow velocity in LAD. SP/ESVI was defined as systolic cuff pressure/end-systolic volume index difference between rest-peak dip-SE.
Results: SP/ESVi was 0.25±0.74 mmHg/ml/m2 in IDC patients and 3.90±2.67 mmHg/ml/m2 in controls. SP/ESVi was not related to ejection fraction at rest, while it was directly related to ejection fraction at peak dip-SE (r=.448, p<.001) and rest-stress difference in ejection fraction (r=.435, p<.001). CFR on LAD was abnormal (<2) in 66 (49%) IDC patients. SP/ESVi was directly related to CFR on LAD (r=.369, p=.001, Figure, red points) in IDC patients: LV contractile reserve affected increase in CFR, while in controls we did not find relationship between SP/ESVi and CFR (Figure, green points).
Conclusions: In IDC with impaired LV systolic function CFR was directly related to LV myocardial contractility, while this relationship disappeared in normal subjects.
Author Disclosures: Q. Ciampi: None. T. Bombardini: None. L. Cortigiani: None. L. Pratali: None. F. Rigo: None. B. Villari: None. E. Picano: None. R. Sicari: None.
- © 2014 by American Heart Association, Inc.