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Midwall mechanics in physiologic and hypertensive concentric hypertrophy
Piercarlo Ballo1, Sergio Mondillo, Francesco Guerrini
1U.O. Cardiologia, Ospedale S. Andrea, via Veneto 197, 19100 La Spezia, Italy. pcballo@tin.it
Summary
Midwall fractional shortening (mFS) is reduced in both athletes and hypertensive patients with left ventricular hypertrophy (LVH). Geometric factors like relative wall thickness (RWT) explain this mFS depression, but hypertension shows a poorer response to stress.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Physiologic concentric left ventricular hypertrophy (LVH) in athletes and hypertensive LVH share geometric similarities.
- Understanding the functional impact of these geometric changes on myocardial performance is crucial.
Purpose of the Study:
- To compare midwall fractional shortening (mFS) in athletes and hypertensive patients with concentric LVH.
- To analyze the relationship between mFS, circumferential end-systolic stress (cESS), and relative wall thickness (RWT) in these groups.
Main Methods:
- Echocardiography was used to assess LV cavity size, wall thickness, LV mass, RWT, cESS, and mFS.
- Study included 51 athletes, 56 hypertensive patients with LVH, and 49 controls.
Main Results:
- Athletes and hypertensive patients showed similar depression in mFS compared to controls.
- This mFS depression was explained by increased RWT and LV mass.
- Hypertensive patients exhibited a steeper negative relationship between mFS and cESS.
Conclusions:
- Geometric factors (RWT, LV mass) are primary determinants of depressed mFS in both physiologic and hypertensive concentric LVH.
- Hypertensive concentric LVH demonstrates an impaired response to varying cESS levels, unlike athletes and controls.