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Longitudinal systolic dysfunction in hypertensive cardiomyopathy with normal ejection fraction.
- Source :
-
Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2022 Jan; Vol. 39 (1), pp. 46-53. Date of Electronic Publication: 2021 Dec 13. - Publication Year :
- 2022
-
Abstract
- Background: The left ventricle (LV) journey in their transition from hypertrophy to heart failure is marked by many subcellular events partially understood yet. The moment in which the structural abnormalities reach the umbral to induce myocardial dysfunction remains elusive.<br />Aims: To evaluate the anatomic-functional relationship between LV wall thickness and longitudinal systolic dysfunction.<br />Material and Methods: We prospectively performed clinical assessment and transthoracic echocardiogram on healthy individuals and hypertensive patients with left ventricle ejection fraction (LVEF) ≥50% and absence of heart failure symptoms.<br />Results: A total of 226 patients and 101 healthy individuals were recruited. The distribution for sex was similar between groups. The mean age was 67±13 years old in the patients, and 44% had concentric LV hypertrophy. LVEF was identical in both groups (63±6%); in contrast, global longitudinal strain (GLS) (-18.8±2.5% vs -20.4±2%) and mitral annulus plane systolic excursion (MAPSE) (13.8±2.8 vs 15.5±2 mm) were lower. ROC curve optimally classified decreased GLS with LV septum thickness ≥13 mm and decreased MAPSE with thickness ≥14 mm. Multivariable logistic regression found that LV septum thickness is the only variable associated with longitudinal systolic dysfunction (OR = 1.1, CI <subscript>95% </subscript> = <subscript> </subscript> 1.05 - 1.15, P = 0.001, R squared = .38).<br />Discussion: A progressive increase in LV wall thickness due to myocyte hypertrophy and interstitial expansion is associated with LV systolic longitudinal dysfunction.<br />Conclusions: Patients with moderate or severe ventricular hypertrophy (septum ≥13 mm) had longitudinal systolic dysfunction, GLS decreases with minor structural change than MAPSE, and LVEF is insensitive in detecting longitudinal myocardial dysfunction in patients with hypertension.<br /> (© 2021 Wiley Periodicals LLC.)
- Subjects :
- Aged
Aged, 80 and over
Humans
Middle Aged
Stroke Volume
Ventricular Function, Left
Cardiomyopathies complications
Cardiomyopathies diagnostic imaging
Hypertension complications
Hypertension diagnostic imaging
Ventricular Dysfunction, Left complications
Ventricular Dysfunction, Left diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8175
- Volume :
- 39
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Echocardiography (Mount Kisco, N.Y.)
- Publication Type :
- Academic Journal
- Accession number :
- 34904277
- Full Text :
- https://doi.org/10.1111/echo.15267