Abstract

Introduction

Materials & Methods

Results

Discussion & Conclusion

References

Discussion
Board

OBJECTIVES. The aim of this study was to state whether in patients with dilated cardiomyopathy (DC) left ventricular (LV) remodeling is related to clinical status, systolic and diastolic LV function. BACKGROUND. Structural modifications of the myocardium (remodeling) after acute myocardial infarction are well studied. However, the role of established LV remodeling in DC needs further evaluation. METHODS. Echocardiography and Doppler cardiac studies were performed in 71 patients with idiopathic DC and 30 controls. RESULTS. It was found that maladaptive ventricular remodeling in DC was accompanied by significant LV dilation and shape distortion, eccentric hypertrophy and raised end-systolic wall stress. Meridional wall stress was predominantly increased. As a result, the ratio of circumferential to meridional wall stress was decreased compared to the control (1.67+/-0.13 vs. 2.13+/-0.11, p < 0.05). Raised LV wall stress was not compensated by myocardial hypertrophy. All patients with DC were divided into three groups according to tertiles of LV diastolic sphericity index (DSI): group I (DSI < 0.777), group II (0.778 < DSI < 0.803) and group III (DSI > 0.804). Across the tertiles there was an increase in the NYHA class, LV myocardial mass, meridional and circumferential end-systolic wall stresses, and a decrease in LV ejection fraction. There was also an increase in the prevalence of the restrictive pattern of LV diastolic filling and severity of mitral regurgitation. CONCLUSIONS. The data indicate that the progression of LV remodeling in DC is associated with more severe heart failure and deteriorated LV systolic function. The prevalence of LV restrictive diastolic filling, as well as the degree of mitral regurgitation also correlates with LV sphericity. These observations lend support to the concept that LV remodeling is a determinant of clinical status and cardiac function in DC.

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Poster Number PAnikitin0616
Keywords: cardiomyopathy, heart ventricle, remodeling, stress, mechanical