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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Relation between plasma amino-terminal propeptide of procollagen type III and left ventricular longitudinal strain in
S H Poulsen1, N H Andersen, L Heickendorff
1Department of Cardiology, Skejby Hospital, Aarhus University Hospital, DK-8200 Aarhus N, Denmark. steen.hvitfeldt@dadlnet.dk
Insights
Essential hypertension is linked to myocardial fibrosis, which impairs left ventricular systolic function. This study found a significant association between fibrosis markers and reduced contractility in hypertensive patients.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Imaging
Background:
- Essential hypertension can lead to cardiac structural changes.
- Myocardial fibrosis is an indicator of cardiac remodeling.
- Assessing fibrosis non-invasively is crucial for understanding hypertensive heart disease.
Purpose of the Study:
- To determine the relationship between non-invasively assessed myocardial fibrosis and left ventricular (LV) longitudinal systolic function.
- To investigate markers of fibrosis in patients with essential hypertension.
- To correlate cardiac function with serological fibrosis markers.
Main Methods:
- The study included 40 hypertensive patients and 30 controls with normal LV ejection fraction.
- Tissue Doppler echocardiography assessed LV longitudinal systolic strain.
- Plasma concentrations of amino-terminal propeptide of type III procollagen (PIIINP) were measured.
Main Results:
- Hypertensive patients showed significantly reduced mean LV longitudinal strain and elevated plasma PIIINP levels compared to controls.
- A significant negative correlation was observed between mean strain and PIIINP (r = -0.56, p < 0.001).
- Patients with abnormal diastolic filling exhibited further reductions in strain and higher PIIINP levels.
Conclusions:
- Myocardial fibrosis is significantly associated with impaired LV longitudinal contractility in essential hypertension.
- Non-invasive assessment of fibrosis may provide insights into cardiac dysfunction in hypertensive individuals.
- These findings highlight the impact of fibrosis on systolic function in hypertension.
Objective:
To investigate whether myocardial fibrosis assessed non-invasively is related to left ventricular (LV) longitudinal systolic function in patients with essential hypertension.
Design:
The study consisted of 30 control subjects and 40 patients with hypertension with normal LV ejection fraction. Tissue Doppler echocardiography was performed to assess LV longitudinal systolic strain from the apical views. Mean strain was calculated from the basal and mid segments. Plasma concentrations of the amino-terminal propeptide of type III procollagen (PIIINP) were measured.
Results:
In the hypertension group, mean strain was significantly reduced (mean (SD) 13 (6)% v 21 (6)%, p < 0.01) and plasma PIIINP were increased compared with controls (3.0 (0.7) microg/l v 2.1 (0.3) microg/l, p < 0.001). A significant correlation was found between mean strain and PIIINP (r = -0.56, p < 0.001). In patients with abnormal diastolic filling (n = 21) mean strain was reduced compared with patients with normal LV filling (n = 19) (10 (6)% v 15 (6)%, p < 0.01) and the serological marker PIIINP was increased (3.5 (0.6) microg/l v 2.5 (0.5) microg/l, p < 0.001).
Conclusions:
There is a significant association between the extent of myocardial fibrosis and reduced LV longitudinal contractility.
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