Journal
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
Volume 25, Issue 8, Pages 882-890Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.echo.2012.04.018
Keywords
Echocardiography; Hypertension; Ventricular-arterial coupling; Strain
Categories
Funding
- European Union [HEALTH-2011-278249-EU-MASCARA, ERC Advanced Grant-2011-294713-EPLORE]
- Fonds Voor Wetenschappelijk Onderzoek Vlaanderen, Ministry of the Flemish Community (Brussels, Belgium) [G.0575.06, G.0734.09]
Ask authors/readers for more resources
Background: To understand better the mechanism of left ventricular (LV) remodeling related to hypertension, it is important to evaluate LV function in relation to the changes in loading conditions. The aim of this study was to investigate changes in conventional ventricular-arterial coupling indexes, LV strain, and a new index reflecting regional myocardial work assessed noninvasively at rest and during isometric exercise in a random sample including participants with normal blood pressure and those with hypertension. Methods: A total of 148 participants (53.4% women; mean age, 52.0 years; 39.2% with hypertension) underwent simultaneous echocardiographic and arterial data acquisition at rest and during increased afterload (handgrip exercise). End-systolic pressure was determined from the carotid pulse wave. Arterial elastance (Ea) and LV elastance (Ees) were calculated as end-systolic pressure/stroke volume and end-systolic pressure/end-systolic volume. Doppler tissue imaging and two-dimensional speckle tracking were used to derive LV longitudinal strain. Regional myocardial work (ejection work density [EWD]) was the area of the pressure-strain loop during ejection. Results: At rest, with adjustments applied, Ees (3.06 vs 3.71 mm Hg/mL, P =. 0003), Ea/Ees (0.54 vs 0.47, P =. 002) and EWD (670 vs 802 Pa/m(2), P = .0001) differed significantly between participants with normal blood pressure and those with hypertension. During handgrip exercise, Ea and Ea/Ees significantly increased (P < .0001) in both groups. Doppler tissue imaging and two-dimensional LV strain decreased in participants with hypertension (P <= .008). Only in subjects with normal blood pressure EWD significantly increased (+14.7%, P = .0009). Conclusions: Although patients with hypertension compared with those with normal blood pressure have increased LV systolic stiffness and regional myocardial work to match arterial load at rest, they might have diminished cardiac reserve to increase myocardial performance, as estimated by EWD during isometric exercise. (J Am Soc Echocardiogr 2012;25:882-90.)
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available