Distribution of myocardial work in arterial hypertension: insights from non-invasive left ventricular pressure-strain relations

Scientific paper - Original scientific paper

• Author: Filip Loncaric
• Author: Maciej Marciniak
• Author: Loredana Nunno
• Author: Maria Mimbrero
• Author: Joao F. Fernandes
• Author: Dora Fabijanovic
• Author: Laura Sanchis
• Author: Adelina Doltra
• Author: Silvia Montserrat
• Author: Maja Čikeš
• Author: Pablo Lamata
• Author: Bart Bijnens
• Author: Marta Sitges
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

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.

• Keywords (english): Arterial Pressure; Case-Control Studies; Echocardiography; Europe; Female; Humans; Hypertension / complications; Hypertension / diagnosis; Hypertension / physiopathology; Hypertrophy, Left Ventricular / diagnostic imaging; Hypertrophy, Left Ventricular / etiology; Hypertrophy, Left Ventricular / physiopathology; Male; Middle Aged; Predictive Value of Tests; Ventricular Dysfunction, Left / diagnostic imaging; Ventricular Dysfunction, Left / etiology; Ventricular Dysfunction, Left / physiopathology; Ventricular Function, Left; Ventricular Pressure; Ventricular Remodeling
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: The International Journal of Cardiovascular Imaging
• Numbering: vol. 37, no. 1, pp. 145-154
• p-ISSN: 1569-5794
• e-ISSN: 1573-0743
• DOI: https://doi.org/10.1007/s10554-020-01969-4
• URN:NBN: urn:nbn:hr:105:946726
• Publication: 2021-08-12
• Document URL: http://link.springer.com/10.1007/s10554-020-01969-4
• Type of resource: Text
• Access conditions: Open access; Embargo expiration date: 2022-02-01
• Created on: 2021-04-20 11:39:32