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Abstract: Poster Presentations |

Vascular Pedicle Width: An Easily Available Tool to Detect Isolated Diastolic Dysfunction FREE TO VIEW

Mobeen Iqbal, MBBS FCCP; Raees Ahmed, MBBS FCCP; Hassan Albalas, MD; Salahuddin Gharad, MD; Fahad D Alotaibi; Ahmed Alarfaj
Author and Funding Information

King Abdul Aziz National Guard Hospital, Alhasa, Saudi Arabia


Chest


Chest. 2003;124(4_MeetingAbstracts):186S-b-187S. doi:10.1378/chest.124.4_MeetingAbstracts.186S-b
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Abstract

PURPOSE:  To study the association of vascular pedicle width on chest roentgenogram with left atrial emptying fraction, an echocardiographic index of diastolic dysfunction.

METHODS:  32 patients with normal systolic function on echocardiogram were evaluated retrospectively for the measurement of left atrial dimensions. Left atrial end-diastolic (LAD) dimensions were measured at the beginning of QRS complex and end-systolic dimensions (LAS) at the end of T-wave on electrocardiogram on M-mode tracing. Left ventricular end-systolic (LVES) and end-diastolic (LVED) diameter, left ventricular septal and posterior wall thickness were also recorded. Postero-anterior (PA) views of chest X-rays done within four weeks of echocardiogram were studied for the measurement of vascular pedicle width (VPW). Left atrial emptying fraction (LAEF) was calculated as LAD/LAS. LAEF > 75% was considered as an indicator of diastolic dysfunction. Patients were divided into Group I (LAEF 75%). Ratio of E to A velocity (E/A) and deceleration time of E-wave (DT) were also recorded on transmitral Doppler signal.

RESULTS:  There were 16 patients in each group. Mean LAEF in Group I was 0.68+0.07 and Group II was 0.83+0.05. There was no significant age difference between the two groups (54.38+17.97 vs. 62.75+14.9;p=0.08). VPW was significantly greater in Group II (VPW62.88+9.07 vs. 48.75+5.48;p<0.0001). Though E/A ratio between two groups was not significant (0.94+0.13 vs. 1.1+0.33) but DT was significantly higher in Group II (223.57+47.83 vs. 177.75+41.66;p<0.01). Septal (1.22+0.27 vs. 1.02+0.31;p<0.03) and posterior wall thickness (0.98+0.23 vs. 1.18+0.21;p<0.01) were significantly higher in Group II.

CONCLUSION:  Vascular pedicle width on PA chest X-ray is significantly increased in patients with LAEF >75%, an index of atrial stretch and diastolic dysfunction, with normal systolic function. Moreover, LAEF>75%, an easy to measure index, can be used to identify patients with diastolic dysfunction.

CLINICAL IMPLICATIONS:  VPW measured on PA chest X-rays can be a reliable indicator of diastolic dysfunction. Left atrial emptying fraction should be routinely measured on echocardiogram with normal systolic function and if found high should prompt further evaluation.

DISCLOSURE:  M. Iqbal, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM


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