Ps-c05-7: association of ventricular-arterial coupling with left ventricular diastolic dysfunction in patients with acute myocardial infarction

Objective: Ventricular-arterial coupling (VAC) has an important role in the pathophysiology of coronary artery disease and heart failure. The association of VAC with left ventricular (LV) function in patients with acute myocardial infarction (AMI) was investigated in this study. Design and Method: Echocardiographic indexes of LV volumes, systolic function, and diastolic function were measured in the usual way. Effective arterial elastance (Ea) was calculated from stroke volume measured using LV outflow waveform. Effective LV end-systolic elastance (Elv) was obtained using the single-beat method. Central aortic pressure waveform was recorded using the applanation tonometry. Characteristic impedance (Zc) of aortic root was calculated after Fourier transformation of both aortic pressure and flow waveforms. Results: Eight-five patients (age 58.5 ± 10.6 years) with AMI were enrolled. They were grouped as patients with reduced EF (rEF, < 50%; n = 27) and preserved ejection fraction (pEF, ≧ 50%; n = 58). In patients with rEF, Ea (2.14 ± 0.55 vs. 1.84 ± 0.51 mmHg/mL; P = 0.017) and VAC (1.18 ± 0.22 vs. 1.02 ± 0.22; P = 0.002) were increased, but peripheral and central systolic blood pressure, Elv and Zc were not different. In multiple linear regression analysis, VAC was significantly associated with E” velocity (beta -0.36, P = 0.001) and Zc (beta 0.33, P = 0.019), but neither with EF nor left ventricular longitudinal strain. The association between VAC and E” velocity was significant in patients with pEF (beta -2.64, P = 0.011), but not in patients with rEF. Conclusions: VAC was associated with LV diastolic dysfunction in AMI patients with pEF, but not with rEF.