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Ann Thorac Surg 2007;83:1356-1360
© 2007 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Left Ventricular Diastolic Dysfunction in Chronic Aortic Dissection

^a Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
^b Department of Medical Technology, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan

Accepted for publication October 27, 2006.

^_* Address correspondence to Dr Shingu, 1-28-706, Nishi 3 chome, Kita 18 jo, Kitaku, Sapporo, Hokkaido 001-0018, Japan (Email: fwpc1650{at}mb.infoweb.ne.jp).

Background: In chronic aortic dissection, compression of the true lumen by the expanded false lumen may be a cause of left ventricular afterload elevation, which may result in diastolic dysfunction. We compared the left ventricular diastolic function by echocardiography between those patients who had double-barrel descending aortic dissection and those who did not.

Methods: Twelve patients (mean age, 61 ± 12 years) with chronic type B aortic dissection were enrolled in this study. Patients in group I had double-barrel aortic dissection that had expanded the patent false lumen and narrowed the true lumen (n = 7, 58.3%), and patients in group II had a wider-caliber true lumen with a thrombosed false lumen (n = 5, 41.7%). We evaluated the left ventricular diastolic function with the transmitral flow pattern (E and A waves) with the pulsed Doppler method and flow propagation velocity (FPV) with color M-mode Doppler images, and classified its severity into grade I (abnormal relaxation), grade II (pseudonormalization) and grade III (restriction).

Results: All patients in group II had grade I diastolic dysfunction, with an E/A of less than 1.0. By contrast, 4 of the 7 patients in group I had grade II diastolic dysfunction, with an FPV/E of less than 0.6 and a pseudonormalized (> 1.0) E/A ratio (p = 0.081). Consequently, the E/A ratio was higher in group I than in group II (1.16 ± 0.39 versus 0.68 ± 0.18; p < 0.05).

Conclusions: It is suggested that left ventricular diastolic function is severely reduced in the patients having aortic dissection with a double-barrel and narrowed true lumen.

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