Myocardial Aspects in Aortic Stenosis and  Functional Increased Afterload Conditions  in Patients with Stressed Heart Morphology

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

doi:10.5761/atcs.lte.21-00035

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…In fact, while a smooth curvature is the case in some patients ( Figure 1 ), another group of hypertensive patients could have extremely predominant BSH without any remodeled segments over the rest of the LV ( Figure 2 ). We have recently described the mechanical component of BSH in aortic stenosis ( Figure 3 ) in addition to the other etiologies including emotional in acute stress cardiomyopathy and functional due to an increased afterload in hypertensive patients [ 28 ]. All these different mechanisms of stress induction in humans may explain a more complex nature for the development of this morphology.…”

Section: Bsh and Animal Validation Studiesmentioning

confidence: 99%

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

Yalçın

Küçukler

et al. 2021

JCM

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Hypertension plays a dominant role in the development of left ventricular (LV) remodeling and heart failure, in addition to being the main risk factor for coronary artery disease. In this review, we focus on the focal geometric and functional tissue aspects of the LV septal base, since basal septal hypertrophy (BSH), as the early imaging biomarker of LV remodeling due to hypertensive heart disease, is detected in cross-sectional clinic studies. In addition, the validation of BSH by animal studies using third generation microimaging and relevant clinical observations are also discussed in the report. Finally, an evaluation of both human and animal quantitative imaging studies and the importance of combined cardiac imaging methods and stress-induction in the separation of adaptive and maladaptive phases of the LV remodeling are pointed out. As a result, BSH, as the early imaging biomarker and quantitative follow-up of functional analysis in hypertension, could possibly contribute to early treatment in a timely fashion in the prevention of hypertensive disease progression to heart failure. A variety of stress stimuli in etiopathogenesis and the difficulty of diagnosing pure hemodynamic overload mediated BSH lead to an absence of the certain prevalence of this particular finding in the population.

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Section: Bsh and Animal Validation Studiesmentioning

confidence: 99%

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

Yalçın

Küçukler

et al. 2021

JCM

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“…Documentation of a pre-existing chronic base in hypertension-mediated pathophysiology in acutely developed stress-related heart diseases such as ASC could be difficult [6]. Early septal LV remodeling, namely, basal septal hypertrophy (BSH) is related to different stressors like exercise hypertension [1], emotional in acute stress cardiomyopathy (ASC), [2,5,6], functional in hypertension-mediated increased afterload [7], and mechanical in aortic stenosis [8]. We validated BSH as the early imaging biomarker and described stressed heart morphology (SHM) as the specific location for superposed multiple stressors [9].…”

Section: Introductionmentioning

confidence: 99%

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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“…Therefore, early left ventricular (LV) remodeling could not only be related to hemodynamic overload since LV base is the largest cavity facing the greatest LV wall stress, but related to sympathetic overdrive since more dominant innervation exists at LV base. We have recently described mechanical component of BSH in aortic stenosis in addition to the other causes including emotional in acute stress cardiomyopathy and functional due to increased afterload in hypertension [4].…”

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confidence: 99%

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

Yalçın

Abraham

2022

Journal of Hypertension

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Myocardial Aspects in Aortic Stenosis and Functional Increased Afterload Conditions in Patients with Stressed Heart Morphology

Cited by 6 publications

References 10 publications

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

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

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

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