Interrelation between midwall mechanics and longitudinal strain in newly diagnosed and never-treated hypertensive patients without clinically defined hypertrophy

Lembo, Maria; Santoro, Ciro; Sorrentino, Regina; Canonico, Mario Enrico; Fazio, Valeria; Trimarco, Bruno; Tadić, Marijana; Galderisi, Maurizio; Esposito, Roberta

doi:10.1097/hjh.0000000000002257

Cited by 16 publications

(15 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We demonstrate that systolic myocardial dysfunction is also part of this adverse cardiometabolic phenotype. Interestingly, low MEE is associated with both reduced MFS and GLS, strongly suggesting that both longitudinally and circumferentially, dysfunction contributes to determining reduced efficiency in obese/overweight individuals as previously reported [28].…”

Section: Discussionsupporting

confidence: 77%

Association of Myocardial Energetic Efficiency with Circumferential and Longitudinal Left Ventricular Myocardial Function in Subjects with Increased Body Mass Index (the FATCOR Study)

Mancusi¹,

Midtbø

Luca³

et al. 2021

JCM

View full text Add to dashboard Cite

Lower myocardial mechanic-energetic efficiency (MEEi), expressed as stroke volume/heart rate ratio (SV/HR) in mL/s/g of the left ventricular (LV) mass, is associated with the incidence of heart failure in subjects with cardiometabolic disorders. We explored the association of MEEi with LV systolic circumferential and longitudinal myocardial function in 480 subjects with increased body mass index (BMI) without known cardiovascular disease (mean age 47 ± 9 years, 61% women, 63% obese, 74% with hypertension) participating in the fat-associated cardiovascular dysfunction (FATCOR) study. Insulin resistance was assessed by the homeostasis model assessment insulin-resistance index (HOMA-IR). SV was calculated by Doppler echocardiography. The LV systolic circumferential myocardial function was evaluated by midwall fractional shortening (MFS) and longitudinal function by global longitudinal strain (GLS). Patients were grouped into MEEi quartiles. The lowest MEEi quartile (< 0.41 mL/s per g) was considered low MEEi. The association of MEEi with MFS and GLS were tested in multivariable linear regression analyses. Patients with low MEEi were more frequently men, with obesity and hypertension, dyslipidemia and higher HOMA-IR index (all p for trend < 0.05). In multivariable analyses, lower MEEi was associated with lower LV myocardial function by MFS and GLS independent of higher LV mass and clinical variables, including older age, male sex, presence of hypertension and a higher triglycerides level (all p < 0.05). In conclusion, in subjects with increased BMI without known cardiovascular disease participating in the FATCOR study, reduced MEEi was associated with lower LV myocardial function both in the circumferential and longitudinal direction, independent of cardiometabolic factors.

show abstract

Section: Discussionsupporting

confidence: 77%

Association of Myocardial Energetic Efficiency with Circumferential and Longitudinal Left Ventricular Myocardial Function in Subjects with Increased Body Mass Index (the FATCOR Study)

Mancusi¹,

Midtbø

Luca³

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“… 19 31 In hypertension, it has been documented that midwall shortening and global longitudinal strain have rather similar performance in detecting subclinical myocardial dysfunction. 32 However, in the present analysis, MEEi predicted higher mortality independent of midwall shortening. Whether MEEi identifies LV myocardial dysfunction comparable with global longitudinal strain could not be tested in the present study since data on global longitudinal strain was not available in the dataset.…”

Section: Discussioncontrasting

confidence: 69%

Low myocardial energetic efficiency is associated with increased mortality in aortic stenosis

et al. 2021

View full text Add to dashboard Cite

ObjectivesIn hypertension, low myocardial energetic efficiency (MEEi) has been documented as an integrated marker of metabolic and left ventricular (LV) myocardial dysfunction. We tested the predictive performance of MEEi in initially asymptomatic aortic stenosis (AS) patients free from diabetes and known cardiovascular disease.MethodsData from 1703 patients with mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study followed for 4.3 years was used. MEE was calculated from Doppler stroke volume/([heart rate/60]) and indexed to LV mass (MEEi). The threshold value for MEEi associated with increased mortality was identified in generalised additive model with smoothing splines. Covariables of MEEi were identified in logistic regression analysis. Outcome was assessed in Cox regression analysis and reported as HR and 95% CI.ResultsMEEi <0.34 mL/s per gram was associated with increased cardiovascular mortality (n=80) (HR 2.53 (95% CI 1.50 to 4.28)) and all-cause mortality (n=155) (HR 1.74 (95% CI 1.20 to 2.52)) (both p<0.01). The association was independent of confounders of low MEEI (<0.34 mL/s per gram) identified in multivariable logistic regression analysis, including more severe AS, higher body mass index, lower LV midwall shortening and ejection fraction and presence of hypertension. Comparison of the Cox models with and without MEEi among the covariables demonstrated that MEEi significantly improved the prognostic yield (both p<0.01).ConclusionsIn patients with initially asymptomatic AS, low MEEi was associated with clustering of cardiometabolic risk factors, lower LV myocardial function and subsequent increased mortality during 4.3 years follow-up, independent of known prognosticators.Trial registration numberNCT00092677.

show abstract

“…To our knowledge, our study was the first to evaluate the relationship between E/e ratio and LV contractile performance during treadmill exercise. Strain deformation is a load-dependent parameter, with previous study 27 demonstrating an inverse correlation between LV pressure load and longitudinal strain, we further found GLSendo was also associated with SBP at peak, our results are therefore more likely to reflect the real impact of hypertension during peak exercise.…”

Section: <001supporting

confidence: 81%

Evaluation of left ventricular function by treadmill exercise stress echocardiography combined with layer‐specific strain technique in essential hypertension patients

Wang

Zhang

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

The purpose of this study was to evaluate the diagnostic utility of treadmill exercise stress echocardiography (TESE) combined with left ventricular (LV) layer-specific strain (LSS) in subclinical myocardial and reserve function of hypertensive patients.A total of 55 hypertensive patients and 51 controls were evaluated during rest and exercise. Two-dimensional speckle tracking (2DST) and LSS technique was used to measure longitudinal and circumferential strains at rest and peak exercise, strain difference characteristics were then evaluated. Compared to the control subjects, both longitudinal and circumferential LSS showed different degrees of reduction in hypertensive group, which was more pronounced at peak exercise. The global longitudinal endocardium strain (GLSendo) at rest was 24.4% ± 1.5% in the control group versus 20.4% ± 2.3% in the hypertensive group, while the difference was more obvious at peak state (control vs. hypertensive group, 30.8% ± 2.8% and 22.8% ± 2.9%, respectively). In particular, endocardial strain under exercise can be used as a sensitive indicator where the LV contractile reserve (CR) function of the three layers are all impaired. TESE combined with LSS might increase diagnostic accuracy of myocardial performance in hypertension patients.

show abstract

Interrelation between midwall mechanics and longitudinal strain in newly diagnosed and never-treated hypertensive patients without clinically defined hypertrophy

Cited by 16 publications

References 40 publications

Association of Myocardial Energetic Efficiency with Circumferential and Longitudinal Left Ventricular Myocardial Function in Subjects with Increased Body Mass Index (the FATCOR Study)

Association of Myocardial Energetic Efficiency with Circumferential and Longitudinal Left Ventricular Myocardial Function in Subjects with Increased Body Mass Index (the FATCOR Study)

Low myocardial energetic efficiency is associated with increased mortality in aortic stenosis

Evaluation of left ventricular function by treadmill exercise stress echocardiography combined with layer‐specific strain technique in essential hypertension patients

Contact Info

Product

Resources

About