Males with abdominal aortic aneurysm have reduced left ventricular systolic and diastolic function.

BACKGROUND

Abdominal aortic aneurysm (AAA) increases the risk of chronic heart failure and other major cardiovascular events. Knowledge about left ventricular function in patients with AAA is lacking. This echocardiographic study aimed to investigate whether AAA is associated with left ventricular systolic and diastolic dysfunction.

METHODS

Echocardiography was performed in 307 males (199 AAA and 108 controls) recruited from a regional ultrasound surveillance programme of known AAA, or from an ongoing ultrasound screening programme, during 2011-2016.

RESULTS

Subjects with AAA had thicker septal and posterior walls and a reduced left ventricular function compared to controls. Left ventricular ejection fraction (AAA 55 ± 8%, controls 57 ± 7%) and global longitudinal strain (AAA 19 ± 3%, controls 20 ± 3%) were lower in the group with AAA (both p < 0·05). Moreover, decreased mitral annular plane systolic excursion (12 ± 2 mm versus 13 ± 2 mm) and higher E/e' (13 ± 5 versus 11 ± 4) were observed in subjects with AAA (both p < 0·05). The aortic sinus (38 ± 4 mm versus 35 ± 2 mm) and ascending aorta (36 ± 4 mm versus 34 ± 5 mm) were also wider in the AAA group compared to controls (both p < 0·01).

CONCLUSION

AAAs are associated with reduced left ventricular systolic and diastolic function in males. The larger diameter of the aortic sinus and ascending aorta among AAA patients suggests that AAA is a general aortic disease.