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European Heart Journal Advance Access originally published online on March 20, 2009
European Heart Journal 2009 30(10):1213-1221; doi:10.1093/eurheartj/ehp084
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Impact of left ventricular volume/mass ratio on diastolic function

Adisai Buakhamsri1,2,{dagger}, Zoran B. Popovic1,{dagger}, Jingna Lin1, Pascal Lim1, Neil L. Greenberg1, Allen G. Borowski1, W.H. Wilson Tang1, Allan L. Klein1, Harry M. Lever1, Milind Y. Desai1 and James D. Thomas1,*

1 Division of Cardiovascular Medicine, Department of Cardiology, Desk F-15, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
2 Faculty of Medicine, Department of Medicine, Thammasat University, Bangkok, Thailand

Received 19 March 2008; revised 1 February 2009; accepted 18 February 2009; online publish-ahead-of-print 20 March 2009.

* Corresponding author. Tel: +1 216 445 6312, Fax: +1 216 445 7306, Email: thomasj{at}ccf.org

Aims: To assess the impact of left ventricular (LV) volume/mass ratio on diastolic function parameters in subjects with dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) and healthy controls.

Methods and results: We performed echocardiography in 44 healthy controls, 35 HCM subjects, 29 DCM subjects with narrow QRS complex (DCM-n), and 27 DCM subjects with wide QRS complex (DCM-w). Mitral annulus velocity (Ea) and transmitral E-wave velocity were used to estimate time constant of isovolumic pressure decay ({tau}). LV flow propagation velocity (Vp) and early intraventricular pressure gradient (IVPG) were derived from colour M-mode of LV inflow. We calculated LV twist and peak untwisting rate (UntwR) by speckle tracking. Mean LV volume/mass ratio was 0.34 ± 0.09 mL/g in healthy controls, 0.15 ± 0.06 mL/g in HCM, 0.6 ± 0.2 mL/g in DCM-n, and 0.8 ± 0.3 mL/g in DCM-w patients (P < 0.001 for all groups). Resting LV ejection fractions were 63 ± 7, 64 ± 8, 31 ± 8, and 26 ± 8%, respectively (P < 0.01 vs. controls for DCM groups). In a multivariate analysis, LV volume/mass ratio remained a strong independent predictor of Vp (P < 0.001), IVPG (P = 0.009), and UntwR (P < 0.001) but not for Ea (P = 0.25).

Conclusion: LV volume/mass ratio had influences on diastolic function parameters independent of intrinsic diastolic function and filling pressures. It should be considered when assessing patients suspected of LV diastolic dysfunction.

Key Words: Left ventricular volume/mass ratio • Diastolic function • Dilated cardiomyopathy • Hypertrophic cardiomyopathy • Ventricular torsion (twist) • Echocardiography

{dagger} The first two authors contributed equally to the study.


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