Left Ventricular Functional Alterations across Types and Severity of Hypertrophy

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Left ventricular hypertrophy (LVH) is a significant risk factor for chronic heart failure, even with preserved ejection fraction (EF).
• Systolic contraction impairment and abnormal diastolic filling are implicated in heart failure progression.
• Understanding LVH's impact on cardiac function is crucial for managing heart failure.

Purpose of the Study:

• To evaluate changes in left ventricular (LV) function across different types and severities of LVH.
• To correlate LVH characteristics with markers of systolic and diastolic dysfunction.
• To assess the role of global longitudinal strain (GLS) in early LV dysfunction detection.

Main Methods:

• Retrospective analysis of 518 echocardiography-confirmed LVH patients.
• Patients categorized by LV mass index, wall thickness, and relative wall thickness.
• Comparison with 707 healthy subjects; analysis of echocardiographic and exercise tolerance data.

Main Results:

• LV function markers (EF, GLS, MV s', TAPSE, TV s') declined progressively with increasing LVH severity.
• Indices of elevated filling pressure (E/e') and pulmonary pressure (RVSP) increased with LVH severity.
• Eccentric LVH mirrored severe LVH; concentric remodeling mirrored mild LVH.

Conclusions:

• LV function parameters (EF, GLS, effort tolerance, MVs', E/e') progressively derange with LVH severity.
• Right ventricular (RV) function (TAPSE, TVs') and pulmonary artery pressure (RVSP) also deteriorate with increasing LVH.
• GLS is a sensitive marker for early LV dysfunction and predicts effort tolerance, even in mild LVH.