Distribution of myocardial work in arterial hypertension: insights from non-invasive left ventricular pressure-strain relations
Copyright policy )Distribution of myocardial work in arterial hypertension: insights from non-invasive left ventricular pressure-strain relations
A index of non-invasive myocardial work (MWI) can account for pressure during the assessment of cardiac function, potentially separating the influence of loading conditions from the influence of the underlying tissue remodelling. The aim is to assess LV function accounted for loading and explore hypertensive MWI distribution by comparing healthy individuals to hypertensive patients without and with localized basal septal hypertrophy (BSH). An echocardiogram was performed in 170 hypertensive patients and 20 healthy individuals. BSH was defined by a basal-to-mid septal wall thickness ratio ≥ 1.4. LV speckle-tracking was performed, and the MWI calculated globally and regionally for the apical, mid and basal regions. An apex-to-base gradient, seen in regional strain values, was preserved in the distribution of myocardial work, with the apical region compensating for the impairment of the basal segments. This functional redistribution was further pronounced in patients with localized BSH. In these patients, segmental MWI analysis revealed underlying impairment of regional work unrelated to acute loading conditions. Non-invasive MWI analysis offers the possibility to compare LV function regardless of blood pressure at the time of observation. Changes in MWI distribution can be seen in hypertension unrelated to the load-dependency of strain. Accentuated functional changes affirm the role of BSH as an echocardiographic marker in hypertension.
- University of Barcelona Spain
- University Hospital Centre Zagreb Croatia
- KU Leuven Belgium
- Kings College London, University of London United Kingdom
- Universitat Pompeu Fabra Spain
Male, Cardiac & Cardiovascular Systems, interna medicina, Hypertension / complications, SYSTEMIC HYPERTENSION, Ventricular Function, Left, Ventricular Dysfunction, Left, basal septal hypertrophy ; hypertension ; myocardial work ; remodeling ; speckle tracking, SEPTAL HYPERTROPHY, Hypertrophy, Left Ventricular / diagnostic imaging, Myocardial work, 1102 Cardiorespiratory Medicine and Haematology, INDEX, Basal septal hypertrophy, remodeling, Hypertrophy, Left Ventricular / etiology, Ventricular Remodeling, Radiology, Nuclear Medicine & Medical Imaging, Ventricular Dysfunction, Left / etiology, Middle Aged, basal septal hypertrophy, Remodeling, myocardial work, Hypertrophy, Left Ventricular / physiopathology, Kliničke medicinske znanosti, Europe, Nuclear Medicine & Medical Imaging, speckle tracking, Biomedicina i zdravstvo, Echocardiography, Hypertension, HEART, Female, Hypertrophy, Left Ventricular, ECHOCARDIOGRAPHY, 3201 Cardiovascular medicine and haematology, Life Sciences & Biomedicine, hypertension, 610, Ventricular Dysfunction, Left / diagnostic imaging, Hypertension / physiopathology, WALL STRESS, Ventricular Dysfunction, Left / physiopathology, DEFORMATION, Predictive Value of Tests, Clinical Medical Sciences, Internal Medicine, Ventricular Pressure, Humans, Arterial Pressure, Biomedicine and Health Sciences, Speckle tracking, Science & Technology, Hypertension / diagnosis, QUANTIFICATION, Case-Control Studies, Cardiovascular System & Cardiology, REGIONAL STRESS
Male, Cardiac & Cardiovascular Systems, interna medicina, Hypertension / complications, SYSTEMIC HYPERTENSION, Ventricular Function, Left, Ventricular Dysfunction, Left, basal septal hypertrophy ; hypertension ; myocardial work ; remodeling ; speckle tracking, SEPTAL HYPERTROPHY, Hypertrophy, Left Ventricular / diagnostic imaging, Myocardial work, 1102 Cardiorespiratory Medicine and Haematology, INDEX, Basal septal hypertrophy, remodeling, Hypertrophy, Left Ventricular / etiology, Ventricular Remodeling, Radiology, Nuclear Medicine & Medical Imaging, Ventricular Dysfunction, Left / etiology, Middle Aged, basal septal hypertrophy, Remodeling, myocardial work, Hypertrophy, Left Ventricular / physiopathology, Kliničke medicinske znanosti, Europe, Nuclear Medicine & Medical Imaging, speckle tracking, Biomedicina i zdravstvo, Echocardiography, Hypertension, HEART, Female, Hypertrophy, Left Ventricular, ECHOCARDIOGRAPHY, 3201 Cardiovascular medicine and haematology, Life Sciences & Biomedicine, hypertension, 610, Ventricular Dysfunction, Left / diagnostic imaging, Hypertension / physiopathology, WALL STRESS, Ventricular Dysfunction, Left / physiopathology, DEFORMATION, Predictive Value of Tests, Clinical Medical Sciences, Internal Medicine, Ventricular Pressure, Humans, Arterial Pressure, Biomedicine and Health Sciences, Speckle tracking, Science & Technology, Hypertension / diagnosis, QUANTIFICATION, Case-Control Studies, Cardiovascular System & Cardiology, REGIONAL STRESS
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