4.5 Article

Altered Aortic Hemodynamics and Relative Pressure in Patients with Dilated Cardiomyopathy

Journal

JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
Volume 15, Issue 4, Pages 692-707

Publisher

SPRINGER
DOI: 10.1007/s12265-021-10181-1

Keywords

Dilated cardiomyopathy; Aortic hemodynamics; Aortic relative pressure; Aortic stiffness; 4D flow MRI

Funding

  1. BHF New Horizons program [NH/11/5/29058]
  2. Engineering and Physical Sciences Research Council [EP/H046410/1, EP/N011554/1, EP/R003866/1]
  3. NIHR Biomedical Research Centre (BRC) at Guy's and St Thomas' NHS Foundation Trust (GSTT) and King's College London
  4. Wellcome Trust-EPSRC Centre of Excellence in Medical Engineering [WT 088641/Z/09/Z]
  5. Department of Health through NIHR Cardiovascular MedTech Co-operative at GSTT
  6. Wallenberg Foundation scholarship program for postdoctoral studies at the Massachusetts Institute of Technology (MIT)
  7. Wellcome Trust Senior Research Fellowship [209450/Z/17/Z]
  8. British Heart Foundation [TG/17/3/33406, PG/15/104/31913]
  9. EPSRC Centre for Medical Engineering at King's College London [WT 203148/Z/16/Z]
  10. Ministry of Science and Higher Education of the Russian Federation [075-152020-926]
  11. Inria-UTSW Medical Center Dallas Associated Team TOFMOD
  12. Ministry of Health of the Czech Republic [NV19-08-00071]
  13. ANID-Millennium Science Initiative Program [NCN17_129]
  14. ANID FONDECYT [1181057]
  15. CONICYT-FONDECYT Postdoctorado [3170737]
  16. ANID FONDECYT de Iniciacion en Investigacion [11200481]
  17. Broad Institute

Ask authors/readers for more resources

This study aimed to explore aortic function in dilated cardiomyopathy (DCM) and found that subjects with reduced left ventricular systolic function had significantly reduced aortic relative pressure, increased aortic stiffness, and significantly delayed time-to-pressure peak duration. Aortic stiffness and aortic volumetric size were identified as key determinants of aortic relative pressure in DCM.
Ventricular-vascular interaction is central in the adaptation to cardiovascular disease. However, cardiomyopathy patients are predominantly monitored using cardiac biomarkers. The aim of this study is therefore to explore aortic function in dilated cardiomyopathy (DCM). Fourteen idiopathic DCM patients and 16 controls underwent cardiac magnetic resonance imaging, with aortic relative pressure derived using physics-based image processing and a virtual cohort utilized to assess the impact of cardiovascular properties on aortic behaviour. Subjects with reduced left ventricular systolic function had significantly reduced aortic relative pressure, increased aortic stiffness, and significantly delayed time-to-pressure peak duration. From the virtual cohort, aortic stiffness and aortic volumetric size were identified as key determinants of aortic relative pressure. As such, this study shows how advanced flow imaging and aortic hemodynamic evaluation could provide novel insights into the manifestation of DCM, with signs of both altered aortic structure and function derived in DCM using our proposed imaging protocol.

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