Early and Quantitative Assessment of Myocardial Deformation in Essential Hypertension Patients by Using Cardiovascular Magnetic Resonance Feature Tracking

Abstract

the aims of the study were to identify subclinical global systolic function abnormalities and evaluate influencing factors associated with left ventricular (LV) strain parameters in hypertensive subjects using cardiovascular magnetic resonance imaging feature tracking (CMR-FT). The study enrolled 57 patients with essential hypertension (mean age: 43.04 ± 10.90 years; 35 males) and 26 healthy volunteers (mean age: 38.69 ± 10.44 years; 11 males) who underwent clinical evaluation and CMR examination. Compared with controls, hypertensive patients had significantly impaired myocardial strain values while ejection fraction (EF) did not differ. After multivariate regression analyses adjustment for confounders, the global radial strains (GRS) was independently associated with the mean arterial pressure (MAP) and left ventricular mass index (LVMI) (β = −0.219, p = 0.009 and β = −0.224, p = 0.015, respectively; Adjusted R 2 = 0.4); the global circumferential strains (GCS) was also independently associated with the MAP and LVMI (β = 0.084, p = 0.002 and β = 0.073, p = 0.01, respectively; Adjusted R 2 = 0.439); the global longitudinal strains (GLS) was independently associated with the Age and MAP (β = 0.065, p = 0.021 and β = 0.077, p = 0.009, respectively; Adjusted R 2 = 0.289). Myocardial strain can early detect the myocardial damage and may be an appropriate target for preventive strategies before abnormalities of EF. Essential hypertension is defined as a rise in blood pressure which can increase risks for cerebral, cardiac, and renal events with unknown reason 1. Hypertension remains deserving for more attention since it is a potent risk factor for cardiovascular diseases and it may brings considerable morbidity and mortality 1-4. Given the prevalence of hypertension in the population, early identifying subclinical left ventricular (LV) systolic dysfunction among hypertensive subjects might have an important role in assessing the prognosis and choosing treatment strategies. Strain imaging has emerged as a sensitive and powerful tool to detect early and subtle myocardial dysfunction in various cardiac diseases, and may provide a novel method for LV risk assessment in hypertensive patients 5-7. Myocardial strain was first used by cardiovascular magnetic resonance (CMR) tagging in 1988 8. CMR tagging has been the most available and reproducible method to quantify the myocardial deformation and remains the reference standard for evaluating myocardial strain 9,10. However, CMR tagging needs to acquire additional sequences and its post processing is time-consuming. The spatial resolution of tagging is quite low, which is another limitation of tagging. Therefore, CMR tagging has not yet been widely applied in clinical circumstances. Speckle tracking echocardiography (STE) has solved these issues to a large extent, but it is still limited by the observer dependency, signal noise, angle dependency, inadequate acoustic windows and poor image quality 11-13. Cardiovascular magnetic resonance imaging feature tracking (CMR-FT), whic...

Correlation between serum miR-122 and myocardial damage and ventricular function in patients with essential hypertension

“…The level of urinary albumin excretion is associated by blood pressure, 24h systolic values and left ventricular function (14). In the early stage of EH, myocardial strain values have been decreased and could be an indicator and treatment target for EH (15). The left atrial function impair and stiffness are presented in EH patients (16).…”

Additive Effects of Obesity on Myocardial Microcirculation and Left Ventricular Deformation in Essential Hypertension: A Contrast-Enhanced Cardiac Magnetic Resonance Imaging Study

“…The results of our study showed that hypertensive patients without obesity had significantly decreased strain values but preserved LVEF compared with control subjects, which confirmed the value of CMR-FT based myocardial deformation analysis in the detection of early and subtle LV dysfunction with previous studies ( 26 , 27 ). A previous CMR-FT study ( 10 ) demonstrated decreased global longitudinal, circumferential and radial PS in essential hypertension. In the present study, the global strain decreased longitudinally but was preserved radially and circumferentially, consistent with an echocardiographic strain study by Sera ( 28 ).…”

“…Myocardial microcirculatory damage is an important mechanism of myocardial impairment ( 5 ) that is associated with cardiac dysfunction ( 6 ), poor prognosis ( 7 ), and adverse outcomes ( 8 ). Although abnormalities of myocardial perfusion and left ventricular (LV) function have been demonstrated separately in hypertension ( 9 , 10 ) and obesity ( 11 , 12 ) separately, their combined effects are still poorly investigated. Elucidation of the interaction between obesity and hypertension may provide insights into mechanisms underlying the impairment of myocardial microcirculation and cardiac function, and may help in identifying patient subgroups that could benefit from early prevention and treatment.…”

DeepStrain Evidence of Asymptomatic Left Ventricular Diastolic and Systolic Dysfunction in Young Adults With Cardiac Risk Factors

“…These discrepancies may be caused by differences between echocardiography, tagging- and cine-MRI imaging modalities, which could be exacerbated when differences in strain are less pronounced. With some exceptions where the mean age was 43 years old ( 26 ), studies in younger populations have not reported radial strain, and to the best of our knowledge none of them has presented regional evaluations.…”

“…Multiple studies in older adults have reported reduced systolic strain with preserved ejection fraction in obesity, hypertension, and T2DM ( 10 , 14 , 15 , 24 , 26 ). For example, cardiac MRI studies measuring global circumferential end-systolic strain have reported a clear reduction in obesity ( 14 ), and progressive decline from controls to hypertension to hypertension with T2DM ( 15 ).…”