Recent Advances in Imaging of Hypertensive Heart Disease

Area of Science:

• Cardiology
• Medical Imaging
• Hypertension Research

Background:

• Hypertensive heart disease (HHD) arises from chronic hypertension, leading to left ventricular hypertrophy and diffuse interstitial fibrosis.
• Diagnosing diffuse fibrosis traditionally necessitated invasive endomyocardial biopsy.
• Advances in cardiac imaging are crucial for noninvasive assessment of HHD complications.

Purpose of the Study:

• To review recent advancements in imaging hypertensive heart disease (HHD).
• To focus on the noninvasive assessment of diffuse myocardial fibrosis using cardiac magnetic resonance (CMR).
• To highlight the role of T1 mapping in CMR for evaluating fibrosis in HHD.

Main Methods:

• Review of recent literature on cardiac imaging techniques for HHD.
• Emphasis on cardiac magnetic resonance (CMR) T1 mapping for assessing diffuse myocardial fibrosis.
• Inclusion of advancements in 3D echocardiography and speckle tracking echocardiography.

Main Results:

• Cardiac magnetic resonance (CMR) T1 mapping enables noninvasive assessment of diffuse myocardial fibrosis.
• Studies show increased extracellular volume fraction (ECV) in HHD patients, indicating ECV as a potential noninvasive fibrosis marker.
• Improved echocardiography techniques allow for accurate volumetric measurements and detection of subclinical systolic dysfunction.

Conclusions:

• Measurement of ECV using CMR T1 mapping serves as a noninvasive marker for diffuse myocardial fibrosis in HHD.
• ECV quantification holds potential for monitoring disease progression and evaluating therapeutic interventions in HHD.
• Further validation with larger cohorts is needed, but ECV shows promise for clinical application in HHD management.