Abnormal right ventricular mechanics in early systemic hypertension: a two-dimensional strain imaging study

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Physiology

Background:

• Systemic blood pressure (BP) is a critical cardiovascular parameter.
• Right ventricular (RV) function plays a vital role in overall cardiac health.
• Subclinical changes in cardiac function can precede overt disease.

Purpose of the Study:

• To investigate the relationship between increasing systemic blood pressure (BP) and right ventricular (RV) function.
• To assess RV function using two-dimensional strain imaging in individuals with varying BP levels.
• To determine if subclinical RV dysfunction occurs at BP levels below conventional hypertension diagnosis.

Main Methods:

• Eighty-nine never-treated, non-obese subjects were evaluated.
• Two-dimensional strain imaging assessed RV free wall and interventricular septum (IVS) longitudinal peak strain and strain rate (SR).
• Conventional echo-Doppler sonography evaluated RV and left ventricular (LV) structure and function, with data analyzed by 24-hour systolic BP (SBP) tertiles.

Main Results:

• RV peak systolic strain and early diastolic SR decreased in the mid-SBP tertile, with no further changes in the highest tertile.
• The interventricular septum (IVS) demonstrated gradated thickening with increasing 24-hour SBP.
• RV and IVS systolic and diastolic strain indices showed an inverse association with increasing septal thickness.

Conclusions:

• Two-dimensional strain imaging reveals RV function is sensitive to elevated systemic BP, even below hypertensive thresholds.
• Subclinical RV systolic and diastolic abnormalities were observed, paralleling BP-induced septal remodeling.
• These findings suggest the interventricular septum's critical role in RV function and its response to BP load.