Could early septal involvement in the remodeling process be related to the advance hypertensive heart disease?

Abstract

BackgroundQuantitative imaging analyses showed an earlier septal wall involvement in hypertension. We planned to determine the effect of hypertension on regional myocardial performance index (MPI) in a hypertensive patient population.MethodsWe evaluated 119 hypertensive patients who were divided into gr. I: 57 patients without left ventricular hypertrophy (LVH), (53.1 ± 10 years), and gr. II: 62 patients with LVH (55.1 ± 9 years) using conventional and tissue doppler imaging. They were compared with gr. III, a sex-age-matched normal control group (37 subjects, 53.0 ± 10 years).ResultsWe detected basal septal and basal lateral contraction time (CT), isovolumetric CT and relaxation time (IVRT) and MPI. EF was 68 ± 5 % in gr. I, 69 ± 5 % in gr. II, 69 ± 4 % in gr. III. LV mass index was 122 ± 11 g/m2 in gr. I, 148 ± 13 g/m2 in gr. II and 118 ± 13 g/m2 in gr. III. Concentric LVH was detected in gr. II (relative wall thickness = 0.49 ± 0.8). LV septal and lateral MPI were abnormal in both hypertensive groups (p < 0.0001). Septal MPI was correlated moderately with septal wall thickness (r = 0.447, p < 0.001).ConclusionsLV diastolic dysfunction becomes more severe in septal wall than lateral wall in hypertensive LVH. Septal myocardial performance is more dominantly affected by hypertension possibly due to earlier septal involvement in disease course. Septal MPI is correlated moderately with septal wall thickness.

Associations of inflammatory markers with impaired left ventricular diastolic and systolic function in collagen-induced arthritis

“…The lateral LV segment was affected to a lesser extent whereas the inferior and posterior walls were unaltered. Previous studies have shown that the septal wall has a greater sensitivity to fibrosis [48] and increased septal myocardial stress has been associated with early structural remodelling in patients with HFpEF [49]. To the best of our knowledge, the present study is the first to demonstrate associations between inflammatory markers with early myocardial deformation in an animal model of RA.…”

Evolution of ventricular hypertrophy and myocardial mechanics in physiological and pathological hypertrophy

“…Functional impairment of the septal base in the early stage may progress more severely in the disease process. In fact, we recently have demonstrated blunted septal mechanical performance compared with the lateral wall in advanced hypertensive disease (39). A clinical study using cardiac magnetic resonance imaging (27) showed that the initial period of LV remodeling under intensive exercise training is associated with asymmetric hypertrophy of the septal base, the closest part of myocardium to increased aterload that is possibly affected by hemodynamic load (2,3,5,29).…”

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

“…Preserved cardiac energy metabolism was another consistent finding in the pressure-overload model before the development of heart failure in Dahl salt-sensitive rats [ 42 ]. Moreover, even we use the terminology of global LV remodeling for advance cases with hypertensive heart disease; we detected predominant septal geometry and more severe septal dysfunction than free wall in this group and speculated that the early involvement of the septum by BSH could possibly be a reason for more severe regional involvement in the LV septum with progression of the disease process [ 43 ].…”