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Left ventricular function and contractile reserve in patients with hypertension
Matle J Fung1,2, Liza Thomas1,2,3, Dominic Y Leung1,2
1Department of Cardiology, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, New South Wales, Australia.
European Heart Journal. Cardiovascular Imaging
|January 5, 2018
Summary
Hypertensive patients show impaired left ventricular (LV) global longitudinal strain (GLS) and contractile reserve (CR) even with normal ejection fraction. LV wall thickness, not blood pressure, independently correlates with this impaired CR.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Hypertension can lead to early left ventricular (LV) systolic dysfunction.
- Contractile reserve (CR) is a sensitive indicator of LV function.
Purpose of the Study:
- To investigate LV CR and its determinants in hypertensive patients compared to normotensive controls.
- To assess if impaired CR is an early sign of systolic dysfunction in hypertension.
Main Methods:
- 129 patients (73 hypertensive) underwent dobutamine echocardiography.
- LV ejection fraction (LVEF) and multi-directional strain (GLS, circumferential, radial) were measured at rest and low-dose dobutamine.
- Absolute and relative CR were calculated; correlations with LV wall thickness and blood pressure were analyzed.
Main Results:
- Hypertensive patients exhibited significantly impaired resting and dobutamine-induced GLS compared to controls.
- Both absolute and relative GLS CR were significantly lower in hypertensive patients.
- LV wall thickness was the sole independent correlate of absolute CR, independent of blood pressure.
Conclusions:
- Hypertensive patients demonstrate impaired LV GLS and CR, even with normal LVEF.
- LV wall thickness is a key factor associated with impaired CR in hypertension.
- These findings suggest CR is a valuable marker for early detection of LV dysfunction in hypertensive individuals.
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