Role of strain echocardiography in patients with hypertension

Oh, Jin Kyung; Park, Jae‐Hyeong

doi:10.1186/s40885-021-00186-y

Cited by 12 publications

(16 citation statements)

References 79 publications

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“…GLS was lower among RH, although LVEF was preserved and similar between CH and RH groups. Thus, just as STE has been pointed as an early marker of myocardial damage, 35 even before any significant change in LVEF, we can assume that decreases in S‐LAr and S‐LAc may represent early evidence of HTN‐induced LA injury.…”

Section: Discussionmentioning

confidence: 90%

Advanced echocardiography techniques (AETs) to assess left atrial structure and function in individuals with resistant hypertension

et al. 2023

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AimsResistant hypertension (RH) is a challenging phenotype within the hypertension (HTN) spectrum, requiring careful assessment and follow‐up. Evaluation of left atrial function may be clinically informative, but is usually neglected. Advanced Echocardiography Techniques (AETs), such as Strain Analysis and three‐dimensional echocardiography (3D ECHO) may be useful complementary tools to assess atrial function in patients with RH.Methods and ResultsNinety‐six eligible adult patients were categorized into three groups: resistant hypertensive (RH), controlled hypertensive (CH), and normotensive (N), and underwent AETs to identify morphofunctional changes in the left atrium (LA) across different HTN phenotypes. The LA reservoir strain was significantly lower among RH than in N and CH patients (p < .001). Accordingly, LA conduit strain showed a gradient through the groups: higher among N, followed by CH and RH patients (p = .015). LA contraction strain was higher among CH than in N and RH patients (p = .02). Maximum indexed, pre‐A, and minimum atrial volumes obtained by 3D ECHO showed differences between N and the others (p < .001), but not between CH and RH. N patients showed a higher fraction of passive emptying of the LA than the others (p = .02), with no difference between CH and RH. Total emptying of the LA only differed between N and RH patients, while active emptying of the LA showed no difference between the groups (p = .82).ConclusionThe left atrium may present early functional changes in response to HTN, which are detectable by AETs. AETs, especially S‐LA, allowed to identify markers of atrial myocardial damage in both RH and CH patients.

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Section: Discussionmentioning

confidence: 90%

Advanced echocardiography techniques (AETs) to assess left atrial structure and function in individuals with resistant hypertension

et al. 2023

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“…Speckle tracking echocardiography with myocardial strain and strain rate is a more sensitive method to detect initial changes in the heart and can identify subtle adaptive changes in LV contractile mechanics in hypertensive patients without symptoms or signs of heart failure and with normal contractile function. 50 , 51 Myocardial strain and strain rate are also more sensitive to early and subtle changes in rodent cardiac function. 52 In this study, although conventional echocardiography did not show any difference between c‐MYPT2 −/− and MYPT2 +/+ mice at baseline, speckle tracking echocardiography showed that radial and longitudinal strain and strain rate were higher in c‐MYPT2 −/− mice than in MYPT2 +/+ mice.…”

Section: Discussionmentioning

confidence: 99%

Myosin Light Chain Phosphatase Plays an Important Role in Cardiac Fibrosis in a Model of Mineralocorticoid Receptor‐Associated Hypertension

Ye,

Okamoto,

Ito

et al. 2024

JAHA

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Background Myosin phosphatase targeting subunit 2 (MYPT2) is an important subunit of cardiac MLC (myosin light chain) phosphatase, which plays a crucial role in regulating the phosphorylation of MLC to phospho‐MLC (p‐MLC). A recent study demonstrated mineralocorticoid receptor‐related hypertension is associated with RhoA/Rho‐associated kinase/MYPT1 signaling upregulation in smooth muscle cells. Our purpose is to investigate the effect of MYPT2 on cardiac function and fibrosis in mineralocorticoid receptor‐related hypertension. Methods and Results HL‐1 murine cardiomyocytes were incubated with different concentrations or durations of aldosterone. After 24‐hour stimulation, aldosterone increased CTGF (connective tissue growth factor) and MYPT2 and decreased p‐MLC in a dose‐dependent manner. MYPT2 knockdown decreased CTGF. Cardiac‐specific MYPT2‐knockout (c‐MYPT2 −/− ) mice exhibited decreased type 1 phosphatase catalytic subunit β and increased p‐MLC. A disease model of mouse was induced by subcutaneous aldosterone and 8% NaCl food for 4 weeks after uninephrectomy. Blood pressure elevation and left ventricular hypertrophy were observed in both c‐MYPT2 −/− and MYPT2 +/+ mice, with no difference in heart weights or nuclear localization of mineralocorticoid receptor in cardiomyocytes. However, c‐MYPT2 −/− mice had higher ejection fraction and fractional shortening on echocardiography after aldosterone treatment. Histopathology revealed less fibrosis, reduced CTGF, and increased p‐MLC in c‐MYPT2 −/− mice. Basal global radial strain and global longitudinal strain were higher in c‐MYPT2 −/− than in MYPT2 +/+ mice. After aldosterone treatment, both global radial strain and global longitudinal strain remained higher in c‐MYPT2 −/− mice compared with MYPT2 +/+ mice. Conclusions Cardiac‐specific MYPT2 knockout leads to decreased myosin light chain phosphatase and increased p‐MLC. MYPT2 deletion prevented cardiac fibrosis and dysfunction in a model of mineralocorticoid receptor‐associated hypertension.

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“…Recently, a systematic review showed that PLWH are at an increased risk of developing hypertension, with those on ART having a higher prevalence due to increasing age, BMI, and chronic inflammation ( 28 ). This is particularly concerning as hypertension is among the most significant risk factors for CVD, potentially leading to cardiac impairment and reduced myocardial strain ( 29 ). In our study, we observed that the impact of hypertension on myocardial function was noticeable even in a relatively young age, highlighting the importance of hypertension management in PLWH.…”

Section: Discussionmentioning

confidence: 99%

Assessment of subclinical cardiac dysfunction by speckle-tracking echocardiography among people living with human immunodeficiency virus

Liao

Toh

Chang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundPeople living with HIV (PLWH) have an increased risk of developing cardiovascular diseases (CVD). As speckle-tracking echocardiography (STE) has been used to detect subclinical myocardial abnormalities, this study aims to detect early cardiac impairment among Asian PLWH using STE and to investigate the associated risk factors.MethodsWe consecutively recruited asymptomatic PLWH without previous CVD from a medical center of Taiwan, and their cardiac function was evaluated by conventional echocardiogram and STE. Enrolled PLWH were classified as antiretroviral therapy (ART)-experienced and ART-naive, and multivariable regressions were used to assess the association between myocardial strain and risk factors including traditional CVD and HIV-associated factors.ResultsA total of 181 PLWH (mean age: 36.4 ± 11.4 years, 173 males) were recruited and conventional echocardiogram parameters were within normal ranges. Decreased myocardial strain across the myocardium was found, with a mean left ventricular (LV) global longitudinal strain of −18.7 ± 2.9%. The LV strain in the ART-experienced group (−19.0 ± 2.9%) was significantly better than the ART-naive group (−17.9 ± 2.8%), despite a younger age and lesser CVD risk factors in the ART-naive group. Hypertension [B = 1.92, 95% confidence interval (95% CI) 0.19–3.62, p = 0.029] and ART-naive with both low and high viral loads (VL) (B = 1.09, 95% CI 0.03–2.16, p = 0.047; and B = 2.00, 95% CI, 0.22–3.79, p = 0.029) were significantly associated with reduced myocardial strain.ConclusionThis is the first and largest cohort using STE to investigate myocardial strain in Asian PLWH. Our results suggest that hypertension and detectable VL are associated with impaired myocardial strain. Thus, timely ART administration with VL suppression and hypertension control are crucial in preventing CVD when making the management parallel with the improved life expectancy of PLWH on ART.

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Role of strain echocardiography in patients with hypertension

Cited by 12 publications

References 79 publications

Advanced echocardiography techniques (AETs) to assess left atrial structure and function in individuals with resistant hypertension

Advanced echocardiography techniques (AETs) to assess left atrial structure and function in individuals with resistant hypertension

Myosin Light Chain Phosphatase Plays an Important Role in Cardiac Fibrosis in a Model of Mineralocorticoid Receptor‐Associated Hypertension

Assessment of subclinical cardiac dysfunction by speckle-tracking echocardiography among people living with human immunodeficiency virus

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