Non-invasive ultrasound-based assessment of ventricular–arterial interaction in vascular Ehlers–Danlos syndrome patients

Abstract

The role of ventricular–arterial hemodynamic interaction in the occurrence of arterial dissection and rupture in vascular Ehlers–Danlos syndrome (vEDS) is unknown. We recently introduced an ultrasound-based method to extract, from common carotid artery (CCA) diameter waveforms, central arterial properties and left ventricular (LV) systolic time intervals. We obtained CCA diameters, compliance and distensibility coefficients, and LV isovolumic contraction and ejection periods (ICP and EP) of 19 vEDS patients (aged 27–65 yrs) and 19 age-matched healthy controls. CCA distension and compliance tended to be lower in vEDS subjects (p = 0.062 and p = 0.073), especially in younger patients. ICP (−12 ms) and EP (−24 ms) were shorter (p < 0.001), while heart rate was increased (+10 bpm; p < 0.001) in vEDS. The ICP/EP ratio and estimated isovolumic dPLV/dt indicated increased LV contractility in vEDS. In conclusion, vascular EDS patients tend to have a lower CCA compliance but a normal pulse pressure, most likely reflecting reduced physical fitness.

Keywords

• Arterial rupture
• Collagen
• Pulse pressure
• Radiofrequency
• Vascular ultrasound
• Ventricular-arterial coupling