Ultrasonic myocardial textural parameters and midwall left ventricular mechanics in essential arterial hypertension

Abstract

Background: The evaluation of the systolic left ventricular performance in hypertensive patients presents some problems related to left ventricular hypertrophy (LVH) which alters the ventricular geometry. The videodensitometric textural ultrasonic analysis of hypertensive myocardium has provided evidence of impairment in the cyclic variation of the mean gray level. This might be considered as an index of intrinsic myocardial function. Objectives: The aim of the present study was to analyse the connection between the midwall fractional shortening and end-systolic stress. The ultrasonic textural parameters in hypertensive patients, arranged in different groups according to the level of LVH and relative wall thickness, were also evaluated. Methods: A group of age-matched (58 ؎ 7 years) male essential hypertensive patients (n ‫؍‬ 70) were compared to a group of normotensive and healthy subjects used as controls (n ‫؍‬ 32). All subjects performed a conventional 2D-Doppler echocardiography to analyse the left ventricular performance. A quantitative analysis of the echocardiographic digitised imaging was also carried out with the help of a calibrated digitisation system in order to calculate the septum and the posterior wall tex-

Myocardial texture in hypertrophic remodelling: new insight into ventricular load and function?

“…That CVI was unrelated to wall thickness per se was important, concordant with that demonstrated in athletes with left ventricular hypertrophy from isometric exercise. Interestingly, Di Bello et al 3 found correlations in hypertensive patients between CVI in the septum and left ventricular posterior wall and midwall fractional shortening, and novel inverse correlations between CVI, systolic blood pressure, left ventricular mass and end-systolic wall stress. The correlations between CVI, blood pressure and myocardial mass were weak, but their directions were consistent with the logic that the higher the arterial blood pressure the greater the left ventricular mass, the more chronic and severe the hypertension, the greater likelihood of interstitial fibrosis and the more intense the backscatter.…”