Sensitive marker for evaluation of hypertensive heart disease: extracellular volume and myocardial strain

Niu, Junqiao; Zeng, Mu Sheng; Wang, Yan; Lee, Jun; Li, Hui; Wang, Shanshan; Zhou, Xiaoyue; Jia, Wang; Li, Yanyu; Feng, Hanping; Zhu, Jianfei

doi:10.1186/s12872-020-01553-7

“…Similarly to speckle tracking echo, feature-tracking derived strains were all demonstrated to be altered in patients affected by AH, strains being more impaired in patients with LVH [84]. In patients with hypertensive heart disease MRI-derived strains were related to both left ventricular mass and ECV [85]. The negative association between GLS by feature tracking and concentric geometry evaluated by LVM/EDV ratio was also confirmed by MRI, similarly to 3Dechocardiography [86].…”

Section: Mrimentioning

confidence: 66%

Advanced imaging tools for evaluating cardiac morphological and functional impairment in hypertensive disease

Lembo

¹

,

Manzi

²

,

Mancusi

³

et al. 2021

Journal of Hypertension

View full text Add to dashboard Cite

Arterial hypertension represents a systemic burden, and it is responsible of various morphological, functional and tissue modifications affecting the heart and the cardiovascular system. Advanced imaging techniques, such as speckle tracking and three-dimensional echocardiography, cardiac magnetic resonance, computed tomography and PET-computed tomography, are able to identify cardiovascular injury at different stages of arterial hypertension, from subclinical alterations and overt organ damage to possible complications related to pressure overload, thus giving a precious contribution for guiding timely and appropriate management and therapy, in order to improve diagnostic accuracy and prevent disease progression. The present review focuses on the peculiarity of different advanced imaging tools to provide information about different and multiple morphological and functional aspects involved in hypertensive cardiovascular injury. This evaluation emphasizes the usefulness of the emerging multiimaging approach for a comprehensive overview of arterial hypertension induced cardiovascular damage.

show abstract

“…Several studies have shown impaired GLS in HTN LVH patients without LGE enhancement despite preserved LVEF [ 30 – 32 ]. GLS tracks myocardium deformation in long axis and disproportional LV thickening, while LVEF is a clinical measure of LV function.…”

Section: Discussionmentioning

confidence: 99%

“…Our results showed that there is a major difference between simulations (~600 ms) and measurements in vivo (~80 ms). The primary cause of [30][31][32]. GLS tracks myocardium deformation in long axis and disproportional LV thickening, while LVEF is a clinical measure of LV function.…”

Section: Discussionmentioning

confidence: 99%

“…Recent evidence also shows a significant correlation between global circumferential strain (GCS) and global extracellular volume fraction (ECV), in patients with nonischemic dilated cardiomyopathy [27], in HCM patients with positive and negative late gadolinium enhancement (LGE) [28], and more broadly in a heterogeneous patient population [29]. In addition, previous studies have investigated strain parameters for monitoring the damaged myocardium in HTN LVH patients [30][31][32].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Myocardium Assessment by Relaxation along Fictitious Field, Extracellular Volume, Feature Tracking, and Myocardial Strain in Hypertensive Patients with Left Ventricular Hypertrophy

Mirmojarabian

¹

,

Lammentausta

²

,

Liukkonen

³

et al. 2022

International Journal of Biomedical Imaging

View full text Add to dashboard Cite

Background. Previous research has shown impaired global longitudinal strain (GLS) and slightly elevated extracellular volume fraction (ECV) in hypertensive patients with left ventricular hypertrophy (HTN LVH). Up to now, only little attention has been paid to interactions between macromolecules and free water in hypertrophied myocardium. Purpose. To evaluate the feasibility of relaxation along a fictitious field with rank 2 (RAFF2) in HTN LVH patients. Study Type. Single institutional case control. Subjects. 9 HTN LVH (age, 69 ± 10 years) and 11 control subjects (age, 54 ± 12 years). Field Strength/Sequence. Relaxation time mapping ( T 1 , T 1 ρ , and T RAFF 2 with 11.8 μT maximum radio frequency field amplitude) was performed at 1.5 T using a Siemens Aera (Erlangen, Germany) scanner equipped with an 18-channel body array coil. Assessment. ECV was calculated using pre- and postcontrast T 1 , and global strains parameters were assessed by Segment CMR (Medviso AB Co, Sweden). The parametric maps of T 1 ρ and T RAFF 2 were computed using a monoexponential model, while the Bloch-McConnell equations were solved numerically to model effect of the chemical exchange during radio frequency pulses. Statistical Tests. Parametric maps were averaged over myocardium for each subject to be used in statistical analysis. Kolmogorov-Smirnov was used as the normality test followed by Student’s t-test and Pearson’s correlation to determine the difference between the HTN LVH patients and controls along with Hedges’ g effect size and the association between variables, respectively. Results. T RAFF 2 decreased statistically 83 ± 2 ms vs 88 ± 6 ms , P < 0.031 , and global longitudinal strain was impaired (GLS, − 14 ± 3 vs − 18 ± 2 , P < 0.002 ) in HTN LVH patients compared to the controls, respectively. Also, significant negative correlation was found between T RAFF 2 and GLS r = − 0.53 , P < 0.05 . Data Conclusion. Our results suggest that T RAFF 2 decrease in HTN LVH patients may be explained by gradual collagen accumulation which can be reflected in GLS changes. Most likely, it increases the water proton interactions and consequently decreases T RAFF 2 before myocardial scarring.

show abstract

“…In another study, GRS was further validated to show significant discriminatory power for identifying LV outflow tract obstruction in patients with HCM ( 19 ). Based on the study from Niu et al, GRS improved obviously after treatment, which suggested that GRS might be an index for evaluating treatment ( 20 ). We also provided evidence that the variation and distribution of circumferential strain were similar to those of the radial orientation.…”

Section: Discussionmentioning

confidence: 99%

The Combination of Feature Tracking and Late Gadolinium Enhancement for Identification Between Hypertrophic Cardiomyopathy and Hypertensive Heart Disease

Liu

¹

,

Li

²

,

Zhao

³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe differentiation between hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) is challenging due to similar myocardial hypertrophic phenotype. The purpose of this study is to evaluate the feasibility of cardiovascular magnetic resonance feature tracking (CMR-FT) and late gadolinium enhancement (LGE) to distinguish between HCM and HHD and the potential relationship between myocardial strain and cardiac functional parameters.MethodsOne hundred and seventy subjects (57 HCM, 45 HHD, and 68 controls) underwent 3.0 T CMR, including steady-state free precession cines and LGE images. Global and segmental (basal, mid, and apical) analyses of myocardial radial, circumferential, longitudinal strain, and left ventricular (LV) torsion, as well as global and 16 segments of LGE were assessed. The multivariate analysis was used to predict the diagnostic ability by combining comprehensive myocardial strain parameters and LGE.ResultsGlobal radial strain (GRS), global circumferential strain (GCS), and LV torsion were significantly higher in the HCM group than in the HHD group (GRS, 21.18 ± 7.52 vs. 14.56 ± 7.46%; GCS, −13.34 ± 3.52 vs. −10.11 ± 4.13%; torsion, 1.79 ± 0.69 vs. 1.23 ± 0.65 deg/cm, all P < 0.001). A similar trend was also seen in the corresponding strain rate. As for segmental strain analysis, basal radial strain (BRS), basal circumferential strain (BCS), basal longitudinal strain (BLS), mid-radial strain (MRS), and mid-circumferential strain (MCS) were higher in the HCM group than in the HHD group (all P < 0.001). The receiver operating characteristic (ROC) results showed that the area under the curve (AUC) of LGE in the mid-interventricular septum (mIVS) was the highest among global and segmental LGE analyses. On the multivariate regression analysis, a combined model of LGE (mIVS) with GRS obtained the highest AUC value, which was 0.835 with 88.89% sensitivity and 70.18% specificity, respectively. In addition, for patients with HCM, GRS, GCS, and global longitudinal strain had correlations with LV ejection fraction (LVEF), maximum interventricular septum thickness (IVST max), and left ventricular mass index (LVMi). Torsion was mildly associated with LVEF.ConclusionCMR-FT-derived myocardial strain and torsion provided valuable methods for evaluation of HCM and HHD. In addition, the combination of GRS and LGE (mIVS) achieved the highest diagnostic value.

show abstract

Sensitive marker for evaluation of hypertensive heart disease: extracellular volume and myocardial strain

Cited by 15 publications

References 21 publications

Advanced imaging tools for evaluating cardiac morphological and functional impairment in hypertensive disease

Advanced imaging tools for evaluating cardiac morphological and functional impairment in hypertensive disease

Myocardium Assessment by Relaxation along Fictitious Field, Extracellular Volume, Feature Tracking, and Myocardial Strain in Hypertensive Patients with Left Ventricular Hypertrophy

The Combination of Feature Tracking and Late Gadolinium Enhancement for Identification Between Hypertrophic Cardiomyopathy and Hypertensive Heart Disease

Contact Info

Product

Resources

About