Abstract 16465: A Lower Than Normal Aortic Diameter is a Prognostic Marker of Cardiac Events in Severe Dilated Cardiomyopathy

IntroductionAn aortic diameter below the lower normal limit is observed in some dilated cardiomyopathy (DCM) patients and its clinical meaning is unknown.HypothesisWe hypothesized that smaller aortic diameter is associated with persisting severe LV dysfunction and can predict worse outcomes, such as the need for left ventricular assist device (LVAD) implantation or death in severe DCM patients.MethodsWe enrolled 73 consecutive patients with DCM (age 43±13 years, 56 males, LV ejection fraction (EF) 19±7 %) who were hospitalized for severe heart failure (HF) (NYHA III or IV) in Osaka University Hospital. The aortic diameter was defined as the diameter of ascending aorta at the level of the pulmonary artery bifurcation measured by multiple detector computed tomography. A small aortic diameter (SA) was defined as a diameter below the lower normal limit adjusted for age, gender and body surface area based on previous report. LV characteristics were obtained by echocardiography. We followed the patients for cardiac events (cardiac death or LVAD implantation).ResultsSA was observed in 35 (48%) patients. The patients with SA had more hospitalizations and lower systolic pressure than those with normal aortic diameter, whereas LVEF and serum level of B-type natriuretic peptide were not significantly different (Table). The patients with SA also had a lower cardiac event free survival (Figure, p