Marijana Tadic1, Cesare Cuspidi2,3, Biljana Pencic1, Vladan Vukomanovic1, Stefano Taddei4, Guido Grassi2, Vera Celic1. 1. Department of Cardiology, University Hospital 'Dr. Dragisa Misovic - Dedinje', Belgrade, Serbia. 2. Department of Medicine and Surgery, University Milano-Bicocca, Milano, Italy. 3. Istituto Auxologico Italiano IRCCS, Clinical Research Unit, Meda, Italy. 4. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Abstract
PURPOSE: The aim of this study was to examine myocardial performance using pressure-strain loops in hypertensive patients with different level of blood pressure control. MATERIAL AND METHODS: This cross-sectional study included 204 subjects (45 controls, 70 patients with well-controlled hypertension, 58 patients with uncontrolled hypertension and 31 patients with resistant hypertension) who underwent complete two-dimensional echocardiographic examination including two-dimensional speckle-tracking echocardiography. Pressure-strain curve was used to determine global myocardial work, constructive work, wasted work and work efficiency in all study participants. RESULTS: Left ventricular (LV) longitudinal strain gradually reduced from controls throughout well-controlled hypertensive patients, to patients with uncontrolled and resistant hypertension. Global myocardial work was higher in patients with uncontrolled and resistant hypertension than in controls and well-controlled hypertension. Constructive work was also higher in all hypertensive patients than in controls. Global wasted work and work efficiency were similar between different groups. Global myocardial work index was associated with peak oxygen consumption independently of sex, age, body mass index (BMI), LV structural and functional parameters in all hypertensive participants. CONCLUSIONS: Myocardial work was significantly deteriorated in patients with uncontrolled and resistant arterial hypertension compared to controls and well-controlled hypertensive patients. Global myocardial work was associated with functional capacity independent of clinical and echocardiographic parameters.
PURPOSE: The aim of this study was to examine myocardial performance using pressure-strain loops in hypertensivepatients with different level of blood pressure control. MATERIAL AND METHODS: This cross-sectional study included 204 subjects (45 controls, 70 patients with well-controlled hypertension, 58 patients with uncontrolled hypertension and 31 patients with resistant hypertension) who underwent complete two-dimensional echocardiographic examination including two-dimensional speckle-tracking echocardiography. Pressure-strain curve was used to determine global myocardial work, constructive work, wasted work and work efficiency in all study participants. RESULTS:Left ventricular (LV) longitudinal strain gradually reduced from controls throughout well-controlled hypertensivepatients, to patients with uncontrolled and resistant hypertension. Global myocardial work was higher in patients with uncontrolled and resistant hypertension than in controls and well-controlled hypertension. Constructive work was also higher in all hypertensivepatients than in controls. Global wasted work and work efficiency were similar between different groups. Global myocardial work index was associated with peak oxygen consumption independently of sex, age, body mass index (BMI), LV structural and functional parameters in all hypertensiveparticipants. CONCLUSIONS: Myocardial work was significantly deteriorated in patients with uncontrolled and resistant arterial hypertension compared to controls and well-controlled hypertensivepatients. Global myocardial work was associated with functional capacity independent of clinical and echocardiographic parameters.
Entities:
Keywords:
Hypertension; left ventricle; myocardial work
Authors: Márton Tokodi; Attila Oláh; Alexandra Fábián; Bálint Károly Lakatos; István Hizoh; Mihály Ruppert; Alex Ali Sayour; Bálint András Barta; Orsolya Kiss; Nóra Sydó; Emese Csulak; Zsuzsanna Ladányi; Béla Merkely; Attila Kovács; Tamás Radovits Journal: Eur Heart J Cardiovasc Imaging Date: 2022-01-24 Impact factor: 6.875