The Study Of Wave Intensity In Assessing Cardiovascular Function In Patients With Dilated Cardiomyopathy

Background and objectiveThe pathophysiology of dilated cardiomyopathy is not fully understood. There is not an adequate classification which could help to predict the survival of patients in the end stage of the disease. The criteria used today, based on clinical symptoms and invasive and noninvasive assessment of the heart function, are far from satisfactory. Wave intensity (WI) is a hemodynamic index, which can evaluate the working condition of the heart interacting with the arterial system. It can be defined at any site in the circulatory system and provides a great deal of information.The objective is to investigate the value of wave intensity (WI) technique in assessing cardiovascular function in patients with dilated cardiomyopathy.Materials and methods1.63 DCM patients (male 42, female 21, mean age 56.4±13.3years) were divided into three groups according to NYHA cardiac functional classification. Group A consisted of patients in classⅡwith a mean age of 54±11.5 years; Group B consisted of patients in classⅢwith a mean age of 50±15.7 years; Group C consisted of patients in classⅣwith a mean age of 61±11.4 years. Control group was 55 normal volunteers that age and gender matched with study population (male 31 and female 24 with a mean age of 43.2±14.5 years).2. A color Doppler ultrasonic system ALOKA Prosoundα10 was used. Right common carotid artery (RCCA) was targeted for ultrasonic imaging to obtain WI parameters which were automatically calculated by WI software. WI parameters included amplitude of the peak during early systole (W1), amplitude of the peak during late systole(W2), area of the negative wave during mid-systole(NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). Left ventricular diameters and volumes in end systole and diastole were measured in 2D echocardiography, then calculated left ventricular ejection fraction (LVEF).ResultsCompared with the control group, W1 and W2 were lower and W1-W2 interval was shorter in DCM groups, while R-W1 interval was longer (P<0.01), and there was no significant difference of NA. Among the groups of DCM, the amplitude of W1 in group B and C was lower than group A. The amplitude of W1 was closely related to LVEF in DCM group.ConclusionsAs a novel technology, WI parameters provide valuable information of relationship between peripheral vascular hemodynamic and ventricular systolic function in patients with DCM. It could be a new exploration in research of left ventricular systolic function, and in some sense, it could provide a criteria for overall and accurate diagnosis of DCM.