Tukker Martijn, Mohamedhoesein Sharida, Kaya Emrah, Schinkel Arend F L, Caliskan Kadir
Department of Cardiology, Office RG-431, Thoraxcenter, Cardiovascular Institute, ErasmusMC University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Department of Cardiology, Reinier de Graaf Hospital, Reinier de Graafweg 5, 2625 AD Delft, The Netherlands.
J Cardiovasc Dev Dis. 2025 Aug 11;12(8):303. doi: 10.3390/jcdd12080303.
Abnormal aortic elasticity serves as a marker for cardiovascular mortality and has a negative impact on the left ventricular (LV) afterload. Noncompaction cardiomyopathy (NCCM) is characterized by hypertrabeculation of the LV endomyocardial wall, with an underdeveloped endocardial helix. This may result in absence of LV twist, disturbed aortic elasticity, LV dysfunction, and ultimately premature heart failure (HF). This study compared the aortic stiffness and clinical outcome in patients with NCCM to that of a control group with dilated cardiomyopathy (DCM). Sixty NCCM patients, matched by age and sex, were compared with 60 DCM controls. Transthoracic echocardiography was performed to measure the systolic (SD) and diastolic diameters (DD) of the ascending aorta. These measurements, along with systolic (SBP) and diastolic blood pressure (DBP), were utilized to calculate the aortic stiffness index defined as ln(SBP/DBP)/[(SD-DD)/DD]. This index was then compared to clinical features and outcome. The mean age was 49 ± 16 years (55% males) in the NCCM group and 49 ± 16 years (55% male) in the DCM group. Aortic stiffness index (ASI) was significantly higher in the NCCM group than in the DCM group (7.0 [5.8-10.2] vs. 6.2 [4.8-7.7], = 0.011). This difference remained statistically significant after adjustment for established risk factors associated with aortic stiffness (β = 1.771; 95% CI [0.253-3.289], = 0.023). Patients with NCCM demonstrated increased aortic stiffness when compared to those with DCM, which may reflect the underlying pathophysiological processes. Additional research is necessary to evaluate the impact of aortic stiffness on the advancement of LV dysfunction, the onset of heart failure, and long-term outcomes.
主动脉弹性异常是心血管死亡的一个标志物,并且对左心室(LV)后负荷有负面影响。非致密化心肌病(NCCM)的特征是左心室心内膜壁肌小梁增多,心内膜螺旋发育不全。这可能导致左心室扭转缺失、主动脉弹性紊乱、左心室功能障碍,并最终导致过早发生心力衰竭(HF)。本研究比较了NCCM患者与扩张型心肌病(DCM)对照组的主动脉僵硬度和临床结局。将60例年龄和性别匹配的NCCM患者与60例DCM对照组进行比较。采用经胸超声心动图测量升主动脉的收缩期(SD)和舒张期直径(DD)。这些测量值,连同收缩压(SBP)和舒张压(DBP),用于计算定义为ln(SBP/DBP)/[(SD - DD)/DD]的主动脉僵硬度指数。然后将该指数与临床特征和结局进行比较。NCCM组的平均年龄为49±16岁(男性占55%),DCM组为49±16岁(男性占55%)。NCCM组的主动脉僵硬度指数(ASI)显著高于DCM组(7.0 [5.8 - 10.2]对6.2 [4.8 - 7.7],P = 0.011)。在对与主动脉僵硬度相关的既定危险因素进行校正后,这种差异仍具有统计学意义(β = 1.771;95%可信区间[0.253 - 3.289],P = 0.023)。与DCM患者相比,NCCM患者表现出主动脉僵硬度增加,这可能反映了潜在的病理生理过程。有必要进行进一步的研究来评估主动脉僵硬度对左心室功能障碍进展、心力衰竭发作和长期结局的影响。