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Huang H, Fu L, Ruan Q, You Z, Yan L. Segmental and global myocardial work in hypertensive patients with different left ventricular geometry. Cardiovasc Ultrasound 2023; 21:11. [PMID: 37370171 DOI: 10.1186/s12947-023-00310-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Myocardial work acquired by echocardiography has emerged as a novel method to evaluate myocardial function. We investigated global and segmental myocardial work in hypertension (HT) among patients with different patterns of left ventricular (LV) geometry in order to analyze the contribution of segmental myocardial work to global myocardial work. METHODS AND RESULTS One hundred twenty-five patients with HT were divided into 4 groups: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH) and eccentric hypertrophy (EH). Longitudinal strain (LS) and the following indices were obtained by echocardiography: myocardial work index (MWI), myocardial constructive work (MCW), myocardial wasted work (MWW), and myocardial work efficiency (MWE). The global longitudinal strain (GLS) decreased gradually among the groups: NG, CR, CH and EH (P < 0.001). Global MWI (GWI) and global MCW (GCW) did not change across the different LV remodeling groups. Global MWW (GWW) increased and global MWE (GWE) decreased in both CH and EH group (P < 0.001). The LS of basal and middle regions reduced gradually in all HT subgroups, while apical LS decreased only in the CH and EH groups (P < 0.001). Basal MWI and MCW decreased in the CH and EH groups (P = 0.025, 0.007, respectively). Apical MWI and MCW increased in the NG and CR groups (P = 0.015, 0.044, respectively), with a decreasing trend in the CH and EH groups. All segmental MWW elevated and MWE reduced significantly in the CH and EH groups (P < 0.001). Univariate and multivariate logistic regression analyses demonstrated a significant association between left atrial volume index (LAVI), GLS, GWE and LV hypertrophy. At the receiver operating characteristic (ROC) analysis, optimal cutoff values of GLS, Apical LS, GWE and Apical MWE discriminating LV hypertrophy were 0.9072, 0.8049, 0.8325 and 0.7414, respectively. CONCLUSION Apical myocardial work increases in the early stages of LV remodeling, likely as a compensatory mechanism to maintain normal global myocardial work. Segmental myocardial work analysis offers a reliable means to explore the distribution of myocardial impairment in hypertensive patients at different LV remodeling stages.
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Affiliation(s)
- Huimei Huang
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, No.20 Chazhong Road, Fuzhou, 350005, China
- Department of Ultrasound, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Liyun Fu
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, No.20 Chazhong Road, Fuzhou, 350005, China
- Department of Ultrasound, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Qinyun Ruan
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, No.20 Chazhong Road, Fuzhou, 350005, China.
- Department of Ultrasound, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
| | - Ziling You
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, No.20 Chazhong Road, Fuzhou, 350005, China
- Department of Ultrasound, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Lei Yan
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, No.20 Chazhong Road, Fuzhou, 350005, China
- Department of Ultrasound, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
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Celik M, Izci S, Kivrak U, Kup A, Kahyaoglu M, Yilmaz Y, Uslu A, Yilmaz AS, Celik FB, Avci A, Cakmak EO, Candan O, Kanal Y, Gecmen C. Quantitative assessment of left atrial functions by speckle tracking echocardiography in hypertensive patients with and without retinopathy. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:759-768. [PMID: 35675314 DOI: 10.1002/jcu.23248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The association between hypertensive retinopathy and left atrial (LA) impairment is unknown. Accordingly, it was aimed to investigate the possible relationship between hypertensive retinopathy and LA phasic functions by means of two-dimensional speckle-tracking echocardiography (2D-STE). METHODS A total of 124 hypertensive patients and 27 control subjects were included in the study. LA reservoir strain (LAS-S ), LA conduit strain (LAS-E ), and LA booster strain (LAS-A ) parameters were used to evaluate LA myocardial functions. RESULTS Hypertensive patients (with and without retinopathy) displayed an obvious reduction in the LA reservoir strain (LAS-S ), and LA conduit strain (LAS-E ). Moreover, further impairment in LA reservoir and conduit strain was found in patients with hypertensive retinopathy than in the isolated hypertensive patients. There were no significant differences in LA booster strain (LAS-A ) among the three groups. Impaired LAS-S (OR: 0.764, CI: 0.657-0.888, and p < 0.001), LAS-E (OR: 0.754, CI: 0.634-0.897, and p = 0.001), and hypertension (HT) duration (OR: 2.345, CI: 1.568-3.507, and p < 0.001) were shown to be independent predictors of hypertensive retinopathy. CONCLUSION Impaired LA reservoir and conduit strain may be used to predict hypertensive patients at higher risk of developing hypertensive retinopathy, and to determine which patients should be followed more closely for hypertensive retinopathy.
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Affiliation(s)
- Mehmet Celik
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Servet Izci
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ulviye Kivrak
- Department of Ophthalmology, Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Kup
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Muzaffer Kahyaoglu
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Cardiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Abdulkadir Uslu
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ahmet Seyda Yilmaz
- Department of Cardiology, Rize Training and Research Hospital, Rize, Turkey
| | - Fatma Betul Celik
- Department of Cardiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Anil Avci
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ender Ozgun Cakmak
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ozkan Candan
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Yucel Kanal
- Department of Cardiology, Tokat State Hospital, Tokat, Turkey
| | - Cetin Gecmen
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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Li X, Dong Y, Zheng C, Wang P, Xu M, Zou C, Wang L. Assessment of real-time three-dimensional echocardiography as a tool for evaluating left atrial volume and function in patients with type 2 diabetes mellitus. Aging (Albany NY) 2020; 13:991-1000. [PMID: 33290260 PMCID: PMC7835035 DOI: 10.18632/aging.202218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023]
Abstract
Objective: To assess the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating changes in left atrial volume and function in type 2 diabetes mellitus (DM) and type 2 diabetic nephropathy (DN) patients. Method: 104 control subjects, 109 DN patients, and 111 DM patients were recruited and underwent RT-3DE. Data pertaining to the left atrium were analyzed using the 3DQA software in order to determine left atrial maximum volume index (LAVImax), left atrial pre-systolic volume index (LAVIp), left atrial minimum volume index (LAVImin), total left atrial ejection fraction (LAEFt), passive left atrial ejection fraction (LAEFp), and active left atrial ejection fraction (LAEFa). Differences between these three groups and correlations between individual index values and E/e' ratios were additionally assessed. Result: LAVImax, LAVIp, and LAVImin were higher in the DN and DM groups relative to controls, whereas LAEFt and LAEFp were higher in controls relative to DM and DN patients (P < 0.05). LAVImax, LAVIp, and LAVImin in the DN group were significantly higher than those in the DM group, while LAEFt, LAEFp were higher in DM patients relative to DN patients (P < 0.05). The E/e' ratio was also found to be significantly correlated with LAVImax, LAVIp, and LAVImin. Conclusion: Our results indicate that RT-3DE can be used to assess changes in left atrial volume and function in patients with diabetes and can be used to monitor disease progression-related damage to such left atrial functionality.
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Affiliation(s)
- Xiuyun Li
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Yanyan Dong
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Chao Zheng
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China
| | - Pengfei Wang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Maosheng Xu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Chunpeng Zou
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Liang Wang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
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Nadar SK. Association between heart failure with preserved ejection fraction and hypertensive retinopathy: more questions than answers! J Hum Hypertens 2018; 32:390-391. [DOI: 10.1038/s41371-017-0022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/03/2017] [Indexed: 11/09/2022]
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