The relationship between left ventricular deformation and different geometric patterns according to the updated classification

Tadić, Marijana; Cuspidi, Cesare; Majstorovic, Anka; Kocijancic, Vesna; Ćelić, Vera

doi:10.1097/hjh.0000000000000618

Cited by 27 publications

(35 citation statements)

References 22 publications

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“…Any factor that impoverished LV subendocardial fibers can lead to increased twist. For example, the systolic twist increases in hypertrophic cardiomyopathy or LV hypertrophy caused by aortic stenosis (16)(17)(18) . Both conditions lead to a subendocardial dysfunction, causing an increased LV twist (19) .…”

Section: Cardiac Motion and Twistmentioning

confidence: 99%

Age-related Changes in the Left Ventricular Twist

Yılmaz¹,

Kılıç²,

Demirtas³

et al. 2017

Kosuyolu Heart Journal

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Introduction: Left ventricular (LV) rotation and twist play important roles in LV contraction and relaxation. Systolic function is usually preserved with aging, but diastolic function deteriorates. The aim of this study was to establish a reference value for LV twist and examine the effect of aging on it. Patients and Methods:We enrolled 75 healthy subjects who were divided into two groups according to age: < 40 and > 40 years. LV rotation and twist were assessed with two-dimensional speckle tracking imaging at the basal and apical levels of the parasternal short axis. LV twist was defined as an apical rotation relative to the baseline. Exclusion criteria included a history of ischemic and valvular disease, arrhythmia, use of a pacemaker, and systolic dysfunction.Results: Peak A wave velocity (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001) and E/E'ratio (7.7 ± 2.2 vs. 6.1 ± 1.3, p< 0.001) were higher and peak E wave velocity (52.4 ± 16 vs. 76.8 ± 11, p< 0.001) and E/A ratio (0.75 vs. 1.34, p< 0.001) were lower in old patients than in young patients. There was an increase in apical rotation (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) and a decrease in basal rotation (−4.1 ± 2.7° vs. −5.2 ± 3.7°, p= 0.185) in old patients, but these changes indicated no significant difference. With aging, the twist increased (8.6 ± 3.3° vs. 8.5 ± 4.1°, p= 0.890), but not significantly. LV apical rotation (5 ± 3.2 vs. 2.4 ± 1.1, p= 0.004) and twist (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) decreased in the old group with an increasing degree of LV diastolic dysfunction. Bulgular: Yaşlılarda gençlere kıyasla pik A dalga hızı (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001), E/E' oranı (7.7 ± 2.23 vs. 6.09 ± 1.3, p< 0.001) daha yüksek, pik E dalga hızı (52.4 ± 16 vs. 76.75 ± 11, p< 0.001), E/A oranı (0.75 vs. 1.34, p< 0.001) daha düşüktü. Yaşlı grupta apikal rotasyonda artış (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) ve bazal rotasyonda azalma (-4.1 ± 2.7° vs. 3.7°± -5.2, p= 0.185) izlendi ancak, bu değişiklikler anlamlı değildi. Yaşlanma ile birlikte, büküm önemsiz derecede arttı (8.6 ± 3.3° vs. 8.53 ± 4.1°, p= 0.890). Yaşlı grupta LV diyastolik disfonksiyon derecesi arttıkça apikal rotasyon (5.02 ± 3.2 vs. 2.4 ± 1.1, p= 0.004) ve büküm (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) azaldı.Sonuç: Bu çalışma LV bükümün yaşla birlikte hafifçe arttığını, ancak bu etkinin sistolik fonksiyonları normal olsada artmış diyastolik disfonksiyon varlığında tersine döndüğünü gösterdi.

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Section: Cardiac Motion and Twistmentioning

confidence: 99%

Age-related Changes in the Left Ventricular Twist

Yılmaz¹,

Kılıç²,

Demirtas³

et al. 2017

Kosuyolu Heart Journal

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“…Several studies have found heterogeneous systolic alterations of the left ventricle (in the longitudinal, radial, and circumferential directions) in diverse clinical settings such as diabetes, hypertension, left ventricle hypertrophy, coronary artery disease, and heart failure [4,6]. The main aim of our study was focused in the assessment of left ventricular mechanical deformation in 20 patients with systemic arterial hypertension and 21 healthy controls to establish the differences in the left ventricular mechanical deformation.…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension represents an increase in cardiac afterload and the compensatory mechanism of is the development of left ventricular concentric hypertrophy. However, unlike hypertrophy which occurs in athletes, the hypertrophy in hypertensive patients occurs with an increase of collagen tissue production, a fact that in the long term leads to left ventricular diastolic dysfunction and secondarily atrial dysfunction by increasing filling pressures predisposing to atrial fibrillation, and in advanced stages systolic dysfunction with dilatation of the cavity and the appearance of heart failure and ventricular arrhythmias [4]. In addition, hypertrophy of the ventricular wall increases the oxygen myocardial demands, which together with the increase incidence of coronary lesions favour myocardial ischemia [5].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, unlike hypertrophy which occurs in athletes, the hypertrophy in hypertensive patients occurs with an increase of collagen tissue production, a fact that in the long term leads to left ventricular diastolic dysfunction and secondarily atrial dysfunction by increasing filling pressures predisposing to atrial fibrillation, and in advanced stages systolic dysfunction with dilatation of the cavity and the appearance of heart failure and ventricular arrhythmias [4]. In addition, hypertrophy of the ventricular wall increases the oxygen myocardial demands, which together with the increase incidence of coronary lesions favour myocardial ischemia [5].Several studies have found heterogeneous systolic alterations of the left ventricle (in the longitudinal, radial, and circumferential directions) in diverse clinical settings such as diabetes, hypertension, left ventricle hypertrophy, coronary artery disease, and heart failure [4,6]. The main aim of our study was focused in the assessment of left ventricular mechanical deformation in 20 patients with systemic arterial hypertension and 21 healthy controls to establish the differences in the left ventricular mechanical deformation.…”

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confidence: 99%

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Mechanical Deformation in Patients with Systemic Arterial Hypertension

Avendaño-Pérez¹,

Soto²,

Ávila-Vanzzini³

et al. 2017

J Hypertens

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IntroductionHypertension is one of the most important healthy problems, and the prevalence is of around 20% of the population (variable in different regions of the world), and the hypertension is one of the most important risk factor for cardiovascular diseases, which are the leading causes of death in developed countries [1,2]. Both elevation of systolic pressure and diastolic blood pressure shows a continuous relationship with cardiovascular risk of stroke, coronary heart disease, heart failure, renal failure and peripheral arterial disease [3].Hypertension can cause left ventricular hypertrophy and hyperplasia of the smooth muscle cells and increased production of collagen and elastin tissue. Hypertension represents an increase in cardiac afterload and the compensatory mechanism of is the development of left ventricular concentric hypertrophy. However, unlike hypertrophy which occurs in athletes, the hypertrophy in hypertensive patients occurs with an increase of collagen tissue production, a fact that in the long term leads to left ventricular diastolic dysfunction and secondarily atrial dysfunction by increasing filling pressures predisposing to atrial fibrillation, and in advanced stages systolic dysfunction with dilatation of the cavity and the appearance of heart failure and ventricular arrhythmias [4]. In addition, hypertrophy of the ventricular wall increases the oxygen myocardial demands, which together with the increase incidence of coronary lesions favour myocardial ischemia [5].Several studies have found heterogeneous systolic alterations of the left ventricle (in the longitudinal, radial, and circumferential directions) in diverse clinical settings such as diabetes, hypertension, left ventricle hypertrophy, coronary artery disease, and heart failure [4,6]. The main aim of our study was focused in the assessment of left ventricular mechanical deformation in 20 patients with systemic arterial hypertension and 21 healthy controls to establish the differences in the left ventricular mechanical deformation. Materials and MethodsBetween March 2016 and February 2017, a comparative, observational, prospective, descriptive and analytical study was carried out in 41 subjects. The patients were evaluated consecutively in the Out-patients Clinic, National Institute of Cardiology "Ignacio Chávez". Twenty patients had systemic hypertension and 21 correspond to healthy controls. All participants signed the informed consent. Inclusion criteriaPatients older than 18 years NYHA functional class I/II with a diagnosis of systemic hypertension who had not had any prior surgical or interventional procedure and also patients without valvular or myocardial lesion. AbstractBackground: Systemic arterial hypertension represents the mayor risk factor for several cardiovascular diseases. In a large number of patients it affects the left ventricle by a compensating hypertrophy and posteriorly when this mechanism is insufficient, it leads to heart failure and therefore the patient requires regular echocardiographic monitoring. ...

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Additional Impact of Aortic Regurgitation on Left Ventricular Strain and Remodeling in Essential Hypertension Patients Evaluated Using MRI

Yan,

Yang,

et al. 2023

Magnetic Resonance Imaging

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BackgroundUnderstanding the impact of aortic regurgitation (AR) on hypertensive patients' hearts is important.PurposeTo assess left ventricular (LV) strain and structure in hypertensive patients and investigate the relationship with AR severity.Study TypeRetrospective.Population263 hypertensive patients (99 with AR) and 62 controls, with cardiac MRI data.Field Strength/SequenceBalanced steady‐state free precession (bSSFP) sequence at 3.0T.AssessmentAR was classified as mild, moderate, or severe based on echocardiographic findings. LV geometry was classified as normal, concentric remodeling, eccentric hypertrophy, or concentric hypertrophy based on MRI assessment of LV mass/volume ratio and LV Mass index (LVMI). LV global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS) were obtained by post‐processing bSSFP cine datasets using commercial software.Statistical TestsANOVA, Kruskal–Wallis test, Spearman's correlation coefficients (r), chi‐square test, and multivariable linear regression analysis. A P value <0.05 was considered statistically significant.ResultsHypertensive patients with AR had significantly lower LV myocardial strain and higher LVMI than the group without AR (GRPS 26.25 ± 12.23 vs. 34.53 ± 9.85, GCPS −17.4 ± 5.84 vs. −20.57 ± 3.57, GLPS −9.86 ± 4.08 vs. −12.95 ± 2.94, LVMI 90.56 ± 38.56 vs.58.84 ± 17.55). Of the 99 patients with AR, 56 had mild AR, 26 had moderate AR and 17 had severe AR. The degree of AR was significantly negatively correlated to the absolute values of LV GRPS, GCPS and GLPS (r = −0.284 – −0.416). LV eccentric hypertrophy increased significantly with AR severity (no AR 21.3%, mild AR 42.9%, moderate AR 73.1%, severe AR 82.4%). In multivariable analysis, the degree of AR was an independent factor affecting LV global strain and LVMI even after considering confounding factors (β values for global myocardial strain were −0.431 to −0.484, for LVMI was 0.646).Data ConclusionIncreasing AR severity leads to decreased cardiac function and worse ventricular geometric phenotypes in hypertensive patients.Level of Evidence4Technical EfficacyStage 3

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The relationship between left ventricular deformation and different geometric patterns according to the updated classification

Cited by 27 publications

References 22 publications

Age-related Changes in the Left Ventricular Twist

Age-related Changes in the Left Ventricular Twist

Mechanical Deformation in Patients with Systemic Arterial Hypertension

Additional Impact of Aortic Regurgitation on Left Ventricular Strain and Remodeling in Essential Hypertension Patients Evaluated Using MRI

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