The impact of high-normal blood pressure on left ventricular mechanics: a three-dimensional and speckle tracking echocardiography study

Tadić, Marijana; Majstorovic, Anka; Penčić, Biljana; Ivanović, Branislava; Nešković, Aleksandar N.; Badano, Luigi P.; Stanisavljević, Dejana; Šćepanović, Radisav; Stevanović, Predrag; Ćelić, Vera

doi:10.1007/s10554-014-0382-3

Cited by 51 publications

(42 citation statements)

References 39 publications

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“…Values were comparable with data from a study including healthy and normotensive power-endurance athletes [24]. For patients with high-normal BP or hypertension, both significantly lower values for left ventricular global strain [24,25] and values comparable to normotensive patients [26] have been published. Probably, the time course of BP elevation plays an important role for the impact on left ventricular mechanics.…”

Section: Discussionsupporting

confidence: 80%

“…Probably, the time course of BP elevation plays an important role for the impact on left ventricular mechanics. Athletes in our study were younger compared to patients with high-normal BP and reduced left ventricular global strain (42 AE 8 vs. 47 AE 7 years, respectively) [25]. An elevated BP may induce a deterioration of diastolic function that precedes the reduction of systolic function.…”

Section: Discussionmentioning

confidence: 62%

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Masked hypertension and cardiac remodeling in middle-aged endurance athletes

Trachsel¹,

Carlen²,

Brugger³

et al. 2015

Journal of Hypertension

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Objectives: Extensive endurance training and arterial hypertension are established risk factors for atrial fibrillation. We aimed to assess the proportion of masked hypertension in endurance athletes and the impact on cardiac remodeling, mechanics, and supraventricular tachycardias (SVT).Methods: Male participants of a 10-mile race were recruited and included if office blood pressure was normal (<140/90 mmHg). Athletes were stratified into a masked hypertension and normotension group by ambulatory blood pressure. Primary endpoint was diastolic function, expressed as peak early diastolic mitral annulus velocity (E'). Left ventricular global strain, left ventricular mass/ volume ratio, left atrial volume index, signal-averaged Pwave duration (SAPWD), and SVT during 24-h Holter monitoring were recorded.Results: From 108 runners recruited, 87 were included in the final analysis. Thirty-three (38%) had masked hypertension. The mean age was 42 AE 8 years. Groups did not differ with respect to age, body composition, cumulative training hours, and 10-mile race time. Athletes with masked hypertension had a lower E' and a higher left ventricular mass/volume ratio. Left ventricular global strain, left atrial volume index, SAPWD, and SVT showed no significant differences between the groups. In multiple linear regression analysis, masked hypertension was independently associated with E' (beta ¼ -0.270, P ¼ 0.004) and left ventricular mass/volume ratio (beta ¼ 0.206, P ¼ 0.049). Cumulative training hours was the only independent predictor for left atrial volume index (beta ¼ 0.474, P < 0.001) and SAPWD (beta ¼ 0.481, P < 0.001). Conclusion:In our study, a relevant proportion of middleaged athletes had masked hypertension, associated with a lower diastolic function and a higher left ventricular mass/ volume ratio, but unrelated to left ventricular systolic function, atrial remodeling, or SVT.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 62%

Masked hypertension and cardiac remodeling in middle-aged endurance athletes

Trachsel¹,

Carlen²,

Brugger³

et al. 2015

Journal of Hypertension

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“…Global area strain (GAS) has been proved to detect early LV systolic dysfunction in athletes, in patients after heart transplantation or after anthracycline therapy, as well as in patients with diabetes and autoimmune disorders [6–10]. Of note, 3D-STE turned out to be less time consuming than 2D in respect to the acquisition and analysis time [11, 12], thus the former has a greater chance to be routinely used in the clinical practice. The aim of our study was to assess whether 3D-STE provides any new information on myocardial deformation in subjects with optimal repair of CoA.…”

Section: Introductionmentioning

confidence: 99%

Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data

et al. 2016

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Aortic coarctation (CoA) in adults is associated with reduced survival. Despite successful repair, some unfavorable changes in the left ventricular (LV) myocardial function are reported. Three-dimensional speckle-tracking imaging (3D-STE) is a novel method that allows to assess regional myocardial function in all directions simultaneously and to calculate global area strain which integrates longitudinal and circumferential deformation. The aim of our study was to assess whether 3-D STE provides any new characteristics of LV deformation in patients with optimal CoA repair. Adults after CoA correction underwent transthoracic echocardiographic examinations. Patients with significant concomitant lesions were ruled out. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were assessed using 3D-STE (Echopac Software, GE). The data were compared with those obtained from healthy subjects. 26 adults (9F/17M; mean age 24.4 years) with repaired CoA were studied. Despite preserved LVEFs, patients with repaired CoA had decreased GAS compared with controls (−28.8 vs. −31.7 %; p = 0.007). No differences between patients and healthy subjects in terms of GLS, GCS and GRS were observed. We found a significant correlation between mean blood pressure and GAS (R = 0.39; p < 0.05). No significant influence of age at repair, CoA correction method or LV mass on three-dimensional deformation was observed. Summarizing, global area strain derived from 3D-STE may be a sensitive indicator of subclinical LV dysfunction in patients after optimal repair of CoA. Mean blood pressure, but not age at correction seems to determine LV deformation.

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“…However, the difference in WMSI was not significant between the non-MI segment group and control group. Although no reduced motions of the non-MI segments were observed visually, myocardial [25], and the significantly reduced GLS, GCS, GRS and GAS seen in subjects with high-normal blood pressure suggesting subclinical myocardial dysfunction [26]. It has also been suggested that GLS may be a sensitive indicator of LV systolic dysfunction in patients with diabetes mellitus even when they demonstrate a normal LVEF [27].…”

Section: Discussionmentioning

confidence: 94%

Evaluation of myocardial infarction size with three-dimensional speckle tracking echocardiography: a comparison with single photon emission computed tomography

Wang

Zhang

Huang

et al. 2015

Int J Cardiovasc Imaging

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To assess whether global and regional myocardial strains from three-dimensional speckle tracking echocardiography (3D-STE) correlate with myocardial infarction size (MIS) detected by single photon emission computed tomography (SPECT). Fifty-seven patients with a history of ST-segment elevation myocardial infarction (MI) within 3-6 months were enrolled, alongside 24 healthy volunteers. Left ventricular (LV) global area strain, global longitudinal strain (GLS), global radial strain, global circumferential strain, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) were measured and compared with the corresponding SPECT-detected MISs. Patients were sub-grouped into massive MIS group (MIS ≥ 12%) and small MIS group (MIS < 12%). Myocardial strains of all the LV segments were compared with the corresponding MIS. Global myocardial strain parameters, LVEF and WMSI of the patients were significantly different from the control group (all P < 0.05) and correlated well with MISs, most significantly for GLS (r = 0.728, P < 0.01). Significant differences in myocardial strain parameters were found between the massive and small MIS groups (all P < 0.05). Receiver operating characteristic curve analysis indicated that GLS had a highest diagnostic value and when the cutoff was -13.8%, the area under the curve was 0.84, with the 70.6% sensitivity and 87.5% specificity. Significant differences of myocardial strain parameters were observed between segments with and without transmural MIs (P < 0.01). 3D-STE myocardial strain parameters evaluated LV global MIS, 3D GLS had the highest diagnostic value. It also preliminarily gauged the degree of ischemia and necrosis of regional myocardial segments.

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The impact of high-normal blood pressure on left ventricular mechanics: a three-dimensional and speckle tracking echocardiography study

Cited by 51 publications

References 39 publications

Masked hypertension and cardiac remodeling in middle-aged endurance athletes

Masked hypertension and cardiac remodeling in middle-aged endurance athletes

Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data

Evaluation of myocardial infarction size with three-dimensional speckle tracking echocardiography: a comparison with single photon emission computed tomography

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