Left ventricular strain and transmural structural remodeling distribution in hypertensive heart disease

Ishizu, Tomoko; Seo, Yoshihiro; Kameda, Yuri; Kimura, Takeshi; Shimojo, Nobutake; Xu, D.; Murakoshi, Nobuyuki; Aonuma, Kazutaka

doi:10.1093/eurheartj/eht309.p3827

Cited by 18 publications

(23 citation statements)

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“…These findings are probably the consequence of myocardial hypertrophy and interstitial fibrosis. Our results suggest that hypertensive heart disease develops in the endocardium—epicardium direction, as it was previously described in animal studies . In conclusion, longitudinal strain could be a surrogate marker of subendocardial fibrosis and a useful parameter for risk stratification in hypertensive patients.…”

Section: Rv Strain In White Coat and Masked Hypertensionsupporting

confidence: 85%

Right heart remodeling induced by arterial hypertension: Could strain assessment be helpful?

Tadić

Cuspidi

Bombelli

2018

J of Clinical Hypertension

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Left ventricular structural and functional changes in patients with arterial hypertension are well established. However, the influence of arterial hypertension on right ventricular (RV) remodeling is still being investigated. The introduction of strain analysis provided an insight into RV function and mechanics. Previous research has demonstrated the predictive value of RV longitudinal strain in patients with various cardiovascular conditions, such as pulmonary hypertension, heart failure, congenital heart diseases, and valvular disease. Nowadays, we are aware of the fact that conventional echocardiographic methods usually do not provide necessary information about RV dysfunction in patients with arterial hypertension, which is why the evaluation of new parameters that could detect RV subtle changes in hypertension is essential. The present review article is an overview of the main principles of RV deformation and a summary of the current knowledge and clinical significance of RV strain in patients with arterial hypertension.

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Section: Rv Strain In White Coat and Masked Hypertensionsupporting

confidence: 85%

Right heart remodeling induced by arterial hypertension: Could strain assessment be helpful?

Tadić

Cuspidi

Bombelli

2018

J of Clinical Hypertension

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“…A previous study using a rat model showed that GLS progressively decreased in hypertensive disease from the early stage up to HF; however GCS was preserved and began to decrease with further pathologic aggravation 17 . The decrease in GLS and GCS was found to be associated with the amount of fibrosis and qualitative abnormality in the endocardium and middle myocardium, respectively 23 . Although not significant, GLS in RA tended to be lower than that of the control group in our study.…”

Section: Discussioncontrasting

confidence: 59%

Impact of biological treatment on left ventricular dysfunction determined by global circumferential, longitudinal and radial strain values using cardiac magnetic resonance imaging in patients with rheumatoid arthritis

Yokoe

Kobayashi

et al. 2020

Int J of Rheum Dis

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Aim: To evaluate left ventricular (LV) dysfunction in patients with rheumatoid arthritis (RA) and to determine the impact of biological treatment on LV function in these patients using global circumferential strain (GCS), global longitudinal strain (GLS) and global radial strain (GRS) values assessed by feature tracking cardiac magnetic resonance (FT-CMR) imaging. Methods: Eighty patients with RA and 20 controls without cardiovascular disease underwent non-contrast CMR imaging. Patients with RA received conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biologic DMARDs (bD-MARDs). Global strains were calculated in 16 LV segments. Results: No significant differences in cardiovascular risk factors were found between the RA group and controls. GCS was 21% lower in the RA group compared with controls (P < 0.001) and was 14% lower in the csDMARDs group compared with the bDMARDs group (P = 0.002), whereas, there was no significant difference in GLS and GRS between the RA group and the controls. In regard to strain rates, diastolic GCS and GRS rates were significantly lower in the RA group (P < 0.001, 0.011, respectively). In univariate analyses, GCS was significantly associated with the Simplified Disease Activity Index, bDMARDs, swollen joint count, anti-cyclic citrullinated peptides antibodies and matrix metalloproteinase-3, but in multivariable analysis, only bDMARDs was significantly associated with GCS (P = 0.021). Conclusion: Global circumferential strain, GLS and GRS assessed by FT-CMR can reveal subclinical LV dysfunction in patients with RA. Furthermore, they can be used to determine the normalization of LV regional dysfunction induced by bDMARDs possibly related to disease activity reduction. How to cite this article: Yokoe I, Kobayashi H, Kobayashi Y, et al. Impact of biological treatment on left ventricular dysfunction determined by global circumferential, longitudinal and radial strain values using cardiac magnetic resonance imaging in patients with rheumatoid arthritis.

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“…A recent study by Rai et al [14] demonstrated that riociguat ameliorated RV ejection fraction and reduced RV fibrosis even under the high pulmonary systolic pressure in a model of pressure overload RV hypertrophy induced by pulmonary artery banding, supporting our data. Ishizu et al [15] reported that LV longitudinal strain could be a surrogate of subendocardial fibrotic change and may be useful for the risk stratification of hypertensive heart failure. If this also applies to the right ventricle, riociguat may ameliorate fibrotic remodeling in patients with PAH, resulting in improved RV longitudinal strain.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Guanylate Cyclase Stimulator, Riociguat, on Right Ventricular Functional Improvement in Patients with Pulmonary Hypertension

et al. 2020

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Background: Riociguat is a soluble guanylate cyclase stimulator that improves hemodynamics in patients with pulmonary hypertension (PH). Accumulating evidence implicates the additional effect of riociguat on the increase in cardiac output. However, its mechanisms have not been fully understood. This study aimed to investigate whether riociguat could ameliorate right ventricular (RV) contraction as well as hemodynamics. Methods: We studied 45 patients with pulmonary arterial hypertension (14) or chronic thromboembolic pulmonary hypertension (31) and evaluated hemodynamics, using right-sided heart catheterization, before and after the administration of riociguat. RV function was assessed by echocardiography, including speckle-tracking echocardiography. Results: Riociguat significantly improved the WHO functional class and reduced the mean pulmonary arterial pressure and vascular resistance. In addition, the cardiac index increased. RV remodeling was ameliorated after riociguat administration as assessed by the echocardiographic parameters, such as RV diameter and RV area index. RV function, including RV fractional area change and RV global longitudinal strain, also significantly improved, and their improvement was even observed in patients with mild PH after pulmonary endarterectomy or balloon pulmonary angioplasty. Furthermore, covariance analysis revealed that RV global longitudinal strain and RV fractional area change improved after riociguat administration, even with the same mean pulmonary arterial pressure, implicating the improvement of RV contractile function by riociguat, regardless of RV loading. Conclusions: Riociguat not only improved the hemodynamics of patients with PH but also ameliorated the echocardiographic parameters with RV function. RV strain could detect the subtle improvement in mild PH, and riociguat may have a benefit even after intervention, as assessed by speckle-tracking echocardiography.

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Left ventricular strain and transmural structural remodeling distribution in hypertensive heart disease

Cited by 18 publications

References 0 publications

Right heart remodeling induced by arterial hypertension: Could strain assessment be helpful?

Right heart remodeling induced by arterial hypertension: Could strain assessment be helpful?

Impact of biological treatment on left ventricular dysfunction determined by global circumferential, longitudinal and radial strain values using cardiac magnetic resonance imaging in patients with rheumatoid arthritis

Clinical Significance of Guanylate Cyclase Stimulator, Riociguat, on Right Ventricular Functional Improvement in Patients with Pulmonary Hypertension

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