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Ultrasonic tissue characterization and Doppler tissue imaging in the analysis of left ventricular function in
Davide Giorgi1, Vitantonio Di Bello, Roberto Pedrinelli
1Cardiac and Thoracic Department, University of Pisa, Pisa, Italy.
Insights
Diastolic abnormalities in arterial hypertension are linked to systolic dysfunction. Ultrasonic tissue characterization reveals impaired left ventricular function in hypertensive patients, progressing with disease severity.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Arterial hypertension can lead to cardiac dysfunction.
- The relationship between systolic and diastolic abnormalities in hypertension requires further investigation.
Purpose of the Study:
- To investigate if diastolic abnormalities are independent of systolic dysfunction in arterial hypertension.
- To evaluate left ventricular intramyocardial function using ultrasonic tissue characterization.
Main Methods:
- Compared three groups: athletes, hypertensive patients, and controls.
- Analyzed ultrasonic myocardial integrated backscatter signals (IBS) and cyclic variation index (CVI(ibs)).
- Utilized Doppler tissue imaging (DTI) to assess myocardial velocities (E(m), A(m)) and E(m)/A(m) ratio.
Main Results:
- Hypertensive patients showed significantly lower CVI(ibs) compared to athletes and controls.
- Lower early diastolic myocardial velocity (E(m)) and higher late diastolic myocardial velocity (A(m)) were observed in hypertensives.
- Significant correlations found between CVI, DTI parameters, and mean arterial pressure.
Conclusions:
- Diastolic abnormalities in arterial hypertension are related to systolic dysfunction.
- Ultrasonic tissue characterization offers a new diagnostic approach for evaluating left ventricular function in hypertension.
Abstract:
It is not known if diastolic abnormalities are independent of systolic dysfunction in arterial hypertension. We studied three groups of 10 male subjects of comparable mean age (31.6 +/- 3.5 years), weight, and height: Athletes (A) (cyclists), essential hypertensive patients (H), and controls (C). Ultrasonic myocardial integrated backscatter signals (IBS) of the septum and the posterior wall were analyzed, while the systo-diastolic variation of the backscatter was considered as a cyclic variation index (CVI(ibs)). Myocardial velocities across the left ventricular major axis were sampled at septum and lateral wall levels by pulsed-wave Doppler tissue imaging (DTI). CVI(ibs) at the septum and the posterior wall were significantly lower in the hypertensive group in comparison with athletes and controls, who were comparable. Early diastolic myocardial velocity (E(m)) of the lateral wall and of the septum were significantly lower in hypertensives, while the late diastolic myocardial velocity (A(m)) was significantly higher in hypertensives in comparison with athletes. The E(m)/A(m) at the septum level was significantly lower in hypertensives in comparison with athletes and controls. Significant correlations were found between CVI and DTI parameters: CVI(ibs) and E(m)/A(m) septum (r = 0.50, P < 0.002). Furthermore, significant correlations were found between mean arterial pressure (MAP) and E(m)/A(m) septum (r = - 0.65, P < 0.001). Ultrasonic tissue characterization with the intrinsic contractility study and the evaluation of the regional diastolic function should, therefore, represent a new integrated diagnostic modality for the evaluation of left ventricular hypertrophied intramyocardial function. This study demonstrated that diastolic abnormalities of left ventricular function, in arterial hypertension, are related and progress with systolic intrinsic dysfunction.