Circumferential versus longitudinal systolic function in patients with hypertension: a nonlinear relation

Area of Science:

• Cardiology
• Cardiovascular Physiology
• Echocardiography

Background:

• Hypertension is linked to early left ventricular (LV) systolic dysfunction.
• Both impaired circumferential midwall and longitudinal function are early indicators.
• The interplay between these indices in hypertensive patients remains unexamined.

Purpose of the Study:

• To analyze the relationship between midwall and longitudinal LV function indices in hypertensive patients.
• To investigate how LV geometry influences this relationship.

Main Methods:

• 126 hypertensive patients were studied.
• Measurements included midwall fractional shortening (mFS), stress-corrected mFS, M-mode atrioventricular plane displacement, and tissue Doppler-derived peak mitral annular systolic velocity.
• Regression analysis was used to determine relationships.

Main Results:

• The relationship between midwall and longitudinal indices was nonlinear.
• Reduced longitudinal function (atrioventricular plane displacement, mitral annular systolic velocity) correlated with smaller decreases in mFS, especially at higher ranges.
• Relative wall thickness was the primary determinant of circumferential and longitudinal contraction efficiency.

Conclusions:

• The relationship between circumferential and longitudinal LV function in hypertension is nonlinear and influenced by LV geometry.
• Systolic dysfunction manifests earlier in longitudinal function compared to circumferential function in hypertensive individuals.