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Altered Aortic Hemodynamics and Relative Pressure in Patients with Dilated Cardiomyopathy

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
JournalJournal of cardiovascular translational research
Early online date9 Dec 2021
DOIs
Accepted/In press2021
E-pub ahead of print9 Dec 2021

Bibliographical note

Funding Information: This work was funded by the BHF New Horizons program (NH/11/5/29058) and by the Engineering and Physical Sciences Research Council (EP/H046410/1 and EP/N011554/1). The research was supported by the NIHR Biomedical Research Centre (BRC) at Guy’s and St Thomas’ NHS Foundation Trust (GSTT) and King’s College London, by the Wellcome Trust-EPSRC Centre of Excellence in Medical Engineering (WT 088641/Z/09/Z), and by the Department of Health through NIHR Cardiovascular MedTech Co-operative at GSTT. D.M. was supported by the Wallenberg Foundation scholarship program for postdoctoral studies at the Massachusetts Institute of Technology (MIT) and Broad Institute. D.N. acknowledges funding from Engineering and Physical Sciences Research Council (EP/N011554/1 and EP/R003866/1). P.L. holds a Wellcome Trust Senior Research Fellowship (209450/Z/17/Z) and acknowledges funding from the British Heart Foundation (TG/17/3/33406). J.M.H. was funded by the EPSRC Centre for Medical Engineering at King’s College London (WT 203148/Z/16/Z), and J.A. also acknowledges funding from the British Heart Foundation (PG/15/104/31913) and the Ministry of Science and Higher Education of the Russian Federation [075–15–2020–926]. R.C. additionally acknowledges the support of Inria-UTSW Medical Center Dallas Associated Team TOFMOD and the Ministry of Health of the Czech Republic (project No. NV19-08–00071). J.S. and S.U. were funded by ANID—Millennium Science Initiative Program—NCN17_129 and ANID FONDECYT #1181057. J.S. also has been supported by CONICYT-FONDECYT Postdoctorado #3170737 and ANID FONDECYT de Iniciación en Investigación #11200481. Publisher Copyright: © 2021, The Author(s).

King's Authors

Abstract

Ventricular-vascular interaction is central in the adaptation to cardiovascular disease. However, cardiomyopathy patients are predominantly monitored using cardiac biomarkers. The aim of this study is therefore to explore aortic function in dilated cardiomyopathy (DCM). Fourteen idiopathic DCM patients and 16 controls underwent cardiac magnetic resonance imaging, with aortic relative pressure derived using physics-based image processing and a virtual cohort utilized to assess the impact of cardiovascular properties on aortic behaviour. Subjects with reduced left ventricular systolic function had significantly reduced aortic relative pressure, increased aortic stiffness, and significantly delayed time-to-pressure peak duration. From the virtual cohort, aortic stiffness and aortic volumetric size were identified as key determinants of aortic relative pressure. As such, this study shows how advanced flow imaging and aortic hemodynamic evaluation could provide novel insights into the manifestation of DCM, with signs of both altered aortic structure and function derived in DCM using our proposed imaging protocol. Graphic Abstractr: [Figure not available: see fulltext.].

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