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[Assessment of regional myocardial systolic function in hypertensive left ventricular hypertrophy using harmonic
Maki Manaka1, Nobuhiro Tanaka, Yasuyoshi Takei
1The Second Department of Internal Medicine, Tokyo Medical University, Tokyo. maki-m@cj8.so-net.ne.jp
Insights
Hypertensive left ventricular hypertrophy impairs myocardial systolic function, starting from the endocardium. This impairment worsens as left ventricular hypertrophy increases, as shown by strain imaging.
Area of Science:
- Cardiology
- Medical Imaging
- Hypertension Research
Background:
- Hypertensive left ventricular hypertrophy (LVH) is a common complication of chronic hypertension.
- Assessing regional myocardial systolic function is crucial for understanding LVH progression.
- Novel imaging techniques like myocardial strain imaging offer new insights into cardiac mechanics.
Purpose of the Study:
- To evaluate regional myocardial systolic function in patients with hypertensive left ventricular hypertrophy.
- To utilize newly developed myocardial strain imaging for this assessment.
- To correlate myocardial strain parameters with left ventricular mass index.
Main Methods:
- Studied 17 patients with hypertensive LVH and 22 normal subjects.
- Measured transmural location of strain peak value (StPP) and strain peak value (StPV) at the posterior wall using myocardial strain imaging.
- Simultaneously measured left ventricular mass index in both groups.
Main Results:
- Strain peak value (StPV) was significantly lower in the LVH group compared to the normal group (p < 0.01).
- Transmural location of strain peak value (StPP) shifted towards the epicardium in the LVH group (p < 0.0001).
- StPV decreased and StPP increased with greater left ventricular mass index (r = -0.61 and r = 0.72, respectively; p < 0.0001 for both).
Conclusions:
- Myocardial systolic impairment in hypertensive LVH may originate from the endocardium.
- The degree of systolic impairment appears to progress with increasing left ventricular hypertrophy.
- Myocardial strain imaging is a valuable tool for detecting early functional changes in hypertensive heart disease.
Objectives:
Regional myocardial systolic function in hypertensive left ventricular hypertrophy was assessed using the newly developed myocardial strain imaging.
Methods:
This study included 17 patients with hypertensive left ventricular hypertrophy (LVH group) and 22 normal subjects (N group). The transmural location of the strain peak value (StPP), and the strain peak value (StPV) in the end-systolic phase were measured at the posterior wall by myocardial strain imaging. Left ventricular mass index was simultaneously measured in both groups.
Results:
StPV was significantly lower in the LVH group than the N group (1.00 +/- 0.36 vs 1.38 +/- 0.42, p < 0.01) and StPP was significantly moved to the epicardium side compared with the N group (31 +/- 10% vs 11 +/- 5%, p < 0.0001). StPV decreased and StPP increased with greater left ventricular mass index (r = -0.61, p < 0.0001; r = 0.72, p < 0.0001, respectively).
Conclusions:
Myocardial systolic impairment in hypertensive left ventricular hypertrophy may occur from the endocardium side, and the impairment may progress with increased left ventricular hypertrophy.
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