Basal septal hypertrophy: extremely sensitive region to variety of stress stimuli and stressed heart morphology

Yalçın, Fatih; Abraham, Roselle; Abraham, Theodore P.

doi:10.1097/hjh.0000000000003043

Cited by 9 publications

(15 citation statements)

References 9 publications

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“…Furthermore, elevated IVS was the strongest cardiac predictor, increasing the risk of perioperative cardiovascular AEs by 2.4-fold. These results may be attributed to myocardial remodeling, resulting in alterations in the cardiac structure, as onset was earliest in the IVS (19,20). Decreased e' aided in confirming which patients were at an increasing risk of poor survival, in both univariate and multivariate regression analysis (6,21).…”

Section: Discussionmentioning

confidence: 94%

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Jiang²,

Zhao³

et al. 2023

Front. Surg.

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BackgroundDiastolic dysfunction (DD), one of the earliest signs of cirrhotic cardiomyopathy (CCM), is included in the revised 2019 CCM criteria. Nonetheless, relevant research regarding the effects of revised DD on post-liver transplantation (LT) outcomes remains limited.MethodsThis retrospective study enrolled patients who underwent LT for decompensated cirrhosis, from January 2018 to March 2021. Patients were divided into DD and non-DD groups. Clinical data were collected. Patients were followed up with, for at least 1 year post-LT; cardiovascular adverse events (AEs) and survival status were recorded. Risk factors were identified using 1:2 propensity score matching (PSM), after adjusting for confounding factors. The caliper value was set to 0.02.ResultsOf 231 patients, 153 were diagnosed with DD (male, 81.8%; mean age, 51.5 ± 9.5 years). Nineteen patients with DD died within 1 year, post-LT. After PSM, 97 and 60 patients were diagnosed with and without DD, respectively. Patients with DD had longer intensive care unit (ICU) stays, higher perioperative cardiovascular AEs, and higher mortality rates than those without DD. In a multivariate analysis, interventricular septum (IVS), left atrial volume index (LAVI), and potassium levels were independent prognostic factors of perioperative cardiovascular AEs, while a decreased early diastolic mitral annular tissue velocity (e’), increased neutrophil-to-lymphocyte ratio (NLR) and tumor markers were predictors of mortality within 1 year post-LT after PSM (P < 0.05).ConclusionCardiac DD may contribute to perioperative cardiovascular AEs and mortality post-LT. Clinicians should be aware of decompensated cirrhosis in patients with DD.

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Section: Discussionmentioning

confidence: 94%

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Jiang²,

Zhao³

et al. 2023

Front. Surg.

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“…In our animal validation study, microimaging showed that physiologic and pathologic stressors lead to a very regularly progressed BSH (Figure 1a,b) differently from human beings [12][13][14]. In fact, we have focused on the psychological background in hypertensives with high stress scores who have shown extremely complex, irregular BSH with a myocardial tissue heterogeneity [9,15,16]. This was the main reason for us to describe SHM as the consequence of superposed multiple stressors.…”

Section: Introductionmentioning

confidence: 94%

“…Panic disorders and emotional distress such as ASC may give rise to tachyarrhythmias with ensuing transient LV dysfunction [24]. We recently have pointed out that chronic stress-mediated SHM as a validated early imaging biomarker possibly plays a pre-existing role and prepares a base for acute emotional episodes [5][6][7]9,[14][15][16].…”

Section: Stress and Brainmentioning

confidence: 99%

“…Like the relation between a variety of body movements and the emotional response of the brain tissue [11], cardiovascular findings and emotions are also related [15][16][17][21][22][23][24]. While chronic cardiovascular disease progression has a complicated and multifactorial transaction including a genetic aspect, some potential missing links could possibly exist between chronic risk factors and sudden attacks like acute coronary syndrome (half of them may not be explained by classical risk factors) or ASC [1][2][3][5][6][7][14][15][16]. Beyond stress mechanics affected by systemic neurohormonal activation [17,29], sympathetic nerve activity could have an additional role [18][19][20].…”

Section: Stress and Heartmentioning

confidence: 99%

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Stress and Heart in Remodeling Process: Multiple Stressors at the Same Time Kill

Yalçin,

Abraham,

Garcia

2024

JCM

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Myocardial remodeling is developed by increased stress in acute or chronic pathophysiologies. Stressed heart morphology (SHM) is a new description representing basal septal hypertrophy (BSH) caused by emotional stress and chronic stress due to increased afterload in hypertension. Acute stress cardiomyopathy (ASC) and hypertension could be together in clinical practice. Therefore, there are some geometric and functional aspects regarding this specific location, septal base under acute and chronic stress stimuli. The findings by our and the other research groups support that hypertension-mediated myocardial involvement could be pre-existed in ASC cases. Beyond a frequently seen predominant base, hyperkinetic tissue response is detected in both hypertension and ASC. Furthermore, hypertension is the responsible factor in recurrent ASC. The most supportive prospective finding is BSH in which a hypercontractile base takes a longer time to exist morphologically than an acutely developed syndrome under both physiologic exercise and pressure overload by transaortic binding in small animals using microimaging. However, cardiac decompensation with apical ballooning could mask the possible underlying hypertensive disease. In fact, enough time for the assessment of previous hypertension history or segmental analysis could not be provided in an emergency unit, since ASC is accepted as an acute coronary syndrome during an acute episode. Additional supportive findings for SHM are increased stress scores in hypertensive BSH and the existence of similar tissue aspects in excessive sympathetic overdrive like pheochromocytoma which could result in both hypertensive disease and ASC. Exercise hypertension as the typical form of blood pressure variability is the sum of physiologic exercise and pathologic increased blood pressure and results in increased mortality. Hypertension is not rare in patients with a high stress score and leads to repetitive attacks in ASC supporting the important role of an emotional component as well as the potential danger due to multiple stressors at the same time. In the current review, the impact of multiple stressors on segmental or global myocardial remodeling and the hazardous potential of multiple stressors at the same time are discussed. As a result, incidentally determined segmental remodeling could be recalled in patients with multiple stressors and contribute to the early and combined management of both hypertension and chronic stress in the prevention of global remodeling and heart failure.

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“…The remodeling process starts on the septal base, which continues for almost half of the course and progresses quite regularly over the midapical segment. This first period is associated with increased tissue dynamics, detected by tissue Doppler, and increased fluid dynamics [ 6 , 7 ].…”

mentioning

confidence: 99%

It Is Time to Focus on “Segmental Remodeling” with Validated Biomarkers as “Stressed Heart Morphology” in Prevention of Heart Failure

Yalçın

García

2022

JCM

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Basal septal hypertrophy: extremely sensitive region to variety of stress stimuli and stressed heart morphology

Cited by 9 publications

References 9 publications

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Stress and Heart in Remodeling Process: Multiple Stressors at the Same Time Kill

It Is Time to Focus on “Segmental Remodeling” with Validated Biomarkers as “Stressed Heart Morphology” in Prevention of Heart Failure

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