Early impairment of left ventricular function in patients with systemic hypertension: New insights with 2-dimensional speckle tracking echocardiography

Sengupta, Shantanu; Caracciolo, Giuseppe; Thompson, Caleb D.; Abe, Haruhiko; Sengupta, Partho P.

doi:10.1016/j.ihj.2012.12.009

Cited by 35 publications

(28 citation statements)

References 20 publications

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“…Specifically, we observed significant subclinical systolic abnormalities (i.e., without impairment of the ejection fraction), which were characterized by low mFS and decreased circumferential strain parameters, but intact longitudinal strain. The evidence of normal longitudinal strain is in contrast with observations from adult patients with hypertension, in whom selective impairment of the longitudinal strain component is the prominent abnormality [26, 27]. However, this finding is consistent with our previous observations in children with CKD secondary to other causes, in whom we equally observed impaired mFS and reduced circumferential strain but normal longitudinal strain [6, 7].…”

Section: Discussionsupporting

confidence: 91%

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

et al. 2019

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Background: No previous study has defined the prevalence of cardiac geometric and mechanical function abnormalities through the analysis of advanced echocardiographic parameters in children with autosomal recessive polycystic kidney disease (ARPKD). Aim: The purpose of this study was to evaluate cardiac geometry and function through advanced echocardiography in a well-characterized sample of pediatric patients with ARPKD. Methods: Standard echocardiograms were obtained in 27 children with ARPKD (0–18 years) and in 88 healthy children of similar age, gender distribution, and body build. Left ventricular (LV) hypertrophy was defined as LV mass > 45g/(m^2.16 + 0.09) and cardiac remodeling was defined by age-adjusted relative wall thickness (RWT). Systolic function was assessed by ejection fraction, midwall fractional shortening (mFS), and global longitudinal (GLS) and circumferential strain (GCS). Results: Patients with ARPKD exhibited a higher LV mass index as compared to controls, and a more concentric LV geometry (both p < 0.001). Accordingly, the prevalence of abnormal LV geometry was significantly higher in ARPKD (33 vs. 0%; p < 0.005). No differences could be observed in the two groups for ejection fraction or GLS (both p = n.s.), while a significantly lower mFS (p < 0.05) as well as GCS (p < 0.001) could be observed. In the analysis of covariance, both LV mass index and RWT remained significantly higher in the ARPKD group, while mFS and GCS remained significantly lower (all p < 0.05). The prevalence of subclinical systolic dysfunction was significantly higher in patients with ARPKD as compared with control subjects (33 vs. 0%; p < 0.001). Conclusions: Children with ARPKD show significantly impaired cardiac phenotype, characterized by high rates of LV abnormal geometry paired with systolic mechanical dysfunction.

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Section: Discussionsupporting

confidence: 91%

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

et al. 2019

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“…The early diastolic longitudinal strain rate was remarkably attenuated compared to the healthy siblings. Previous studies have suggested that the development of hypertension and increased afterload are associated with a reduction in GLS . Our data suggest the presence of a genetic servo mechanism by which, during early stages of HHD, the genetic blueprint can conserve the global cardiac contraction towards a set normal value at end‐systole, although acquired factors associated with the development of hypertension start changing LV relaxation mechanics within the early diastolic phase.…”

Section: Discussionmentioning

confidence: 52%

“…Arterial hypertension may cause changes in LV morphology and the deterioration of biomechanical function even before the onset of heart failure symptoms . The treated HTN siblings in our study had no cardiac structural alterations or systolic dysfunction.…”

Section: Discussionmentioning

confidence: 55%

Genetically determined pattern of left ventricular function in normal and hypertensive hearts

Kovács

Molnár

Kolossváry

et al. 2018

J of Clinical Hypertension

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We sought to assess the inheritance of left ventricular (LV) function using speckle-tracking echocardiography and the impact of hypertension on modifying the genetically determined pattern of contraction in a population of twins. We recruited 92 Caucasian twin pairs, including 74 hypertensive (HTN) siblings. Beyond standard echocardiographic protocol, a speckle-tracking analysis was performed, including global longitudinal strain (GLS). Systolic function, as assessed by ejection fraction, showed moderate heritability (61%); however, GLS showed higher and dominant heritability (75%). Heterogeneity models revealed that there were no differences between the HTN and non-HTN subjects regarding the heritability of GLS. However, the heritability estimates of diastolic function parameters, including early diastolic strain rate, were low. LV systolic biomechanics is highly heritable. GLS shows dominant heritability, despite the presence of early-stage hypertensive heart disease. Early diastolic parameters are rather determined by environmental factors. These findings suggest the presence of a genetic framework that conserves systolic function despite the expression of diastolic dysfunction and may underlie the phenotypic progression towards heart failure with preserved ejection fraction.

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“…This factor is also applicable to a study conducted by Barutçu et al, 24 who showed that diabetes and hypertension could impair LV systolic and diastolic deformation. [25][26][27][28][29][30] As a result, the strength of our study compared with that study was the one-to-one matching of the patient and control groups regarding hypertension and diabetes mellitus. Vendor differences (GE versus Medison) and matching method differences (frequency versus individual) may explain these different results.…”

Section: Discussionmentioning

confidence: 92%

Effect of Coronary Slow Flow on the Longitudinal Left Ventricular Function Assessed by 2‐Dimensional Speckle‐Tracking Echocardiography

Narimani

Hosseinsabet

Pourhosseini

2016

J of Ultrasound Medicine

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Early impairment of left ventricular function in patients with systemic hypertension: New insights with 2-dimensional speckle tracking echocardiography

Cited by 35 publications

References 20 publications

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

Genetically determined pattern of left ventricular function in normal and hypertensive hearts

Effect of Coronary Slow Flow on the Longitudinal Left Ventricular Function Assessed by 2‐Dimensional Speckle‐Tracking Echocardiography

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