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Multimodality cardiovascular imaging in hypertension
Tiffany Dong1, Christian Faaborg-Andersen2, Mariana Garcia3
1Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Insights
Hypertension significantly contributes to cardiovascular mortality. This review explores noninvasive imaging techniques like echocardiography and MRI for evaluating hypertensive heart disease.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Hypertension is a leading cause of global cardiovascular mortality.
- Current guidelines offer limited direction on noninvasive imaging for hypertensive adults.
- Hypertensive heart disease assessment requires refined diagnostic strategies.
Approach:
- This review synthesizes current applications of noninvasive cardiovascular imaging.
- modalities discussed include echocardiography, nuclear imaging, CT, and MRI.
- The focus is on evaluating cardiac changes due to sustained hypertension.
Key Points:
- Echocardiography serves as an initial screening tool for hypertensive patients.
- Advanced imaging modalities like CT and MRI aid in diagnosing left ventricular hypertrophy.
- Nuclear imaging assists in identifying alternative or complementary diagnoses.
Conclusions:
- Noninvasive imaging plays a crucial role in assessing hypertensive heart disease.
- A multi-modality imaging approach can optimize patient evaluation and management.
- Further research is needed to fully define imaging's role in hypertension care.
Purpose Of The Review:
Hypertension accounts for the largest proportion of cardiovascular (CV) mortality worldwide and its prevalence continues to rise. While prominent CV societies have offered strong recommendations on the management of hypertension in adults, the role of noninvasive CV imaging in the evaluation of hypertensive patients remains incompletely defined.
Recent Findings:
Noninvasive imaging is a rapidly expanding field with a growing number of sophisticated and readily applicable modalities to assess how cardiac structure and function changes after periods of sustained, elevated blood pressure. Echocardiography remains the initial modality to screen these patients while developments in nuclear, computed tomography and cardiac magnetic resonance complement and expand investigations for alternative diagnoses that may complement or conflict with the diagnosis of left ventricular hypertrophy.
Summary:
In this review article, we summarize the application of echocardiography, nuclear imaging, cardiac computed tomography, and cardiac magnetic resonance imaging in the evaluation and management of hypertensive heart disease.
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