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Gao L, Ma W, Li M, Yang Y, Qi L, Zhang B, Wang C, Zhang Y, Huo Y. Association between basal septal hypertrophy and left ventricular geometry in a community population. BMC Cardiovasc Disord 2022; 22:579. [PMID: 36587201 PMCID: PMC9805678 DOI: 10.1186/s12872-022-03004-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 12/12/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Left ventricular (LV) geometry is closely associated with cardiovascular disease; however, few studies have evaluated the relationship between basal septal hypertrophy (BSH) and LV geometry. In this study, we examined the relationship between BSH and LV geometry in a Beijing community population. METHODS The clinical and echocardiographic data of 1032 participants from a community in Beijing were analyzed. BSH was defined as a basal interventricular septal thickness ≥ 14 mm and a basal septal thickness/mid-septal thickness ≥ 1.3. On the basis of their echocardiographic characteristics, patients were described as having a normal geometry, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy. Multivariable logistic regression was used to analyze the relationship between BSH, LV mass index (LVMI), and relative wall thickness (RWT). RESULTS The prevalence of BSH was 7.4% (95% confidence interval [CI] 5.8-9.0%). Basal and middle interventricular septal thickness, LV posterior wall thickness, and RWT were greater, while LVMI and LV end-diastolic dimension were lower in the BSH group than in the non-BSH group (p < 0.05). The BSH group accounted for the highest proportion of patients with concentric remodeling. A multivariable regression analysis showed that BSH increased by 3.99-times (odds ratio [OR] 3.99, 95% CI 2.05-7.78, p < 0.01) when RWT was > 0.42, but not when LVMI increased (OR 0.16, 95% CI 0.02-1.19, p = 0.07). There were no interactions between BSH and age, body mass index, sex, diabetes mellitus, coronary heart disease, stroke, and smoking in relation to an RWT > 0.42. CONCLUSION BSH was independently associated with an RWT > 0.42.
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Affiliation(s)
- Lan Gao
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Wei Ma
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Min Li
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China
| | - Ying Yang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Litong Qi
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Baowei Zhang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Chonghui Wang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China
| | - Yan Zhang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yong Huo
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
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Yalçin F, Yalçin H, Abraham R, Abraham TP. Hemodynamic stress and microscopic remodeling. Int J Cardiol Cardiovasc Risk Prev 2021; 11:200115. [PMID: 34806089 PMCID: PMC8586739 DOI: 10.1016/j.ijcrp.2021.200115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUD Heart responds to physiologic and pathologic conditions and sympathetic drive plays an important role. It has been documented that LV base is more dominantly affected by sympathetic drive compared to the other regions. LV base is more dominantly exposed to wall stress in the initial period of remodeling due to pressure-overload, since LV cavity is the largest at base. Basal septal hypertrophy (BSH) in cross-sectional data is associated with the early phase of hypertensive heart disease. BSH was confirmed by 3rd generation microscopic ultrasound in small animals. BSH as the closest location to increased afterload could be detected in variety of stress stimuli and result in a huge septal hypertrophy in advance cases possibly related to earlier exposure of hemodynamic stress to septal wall. CONCLUSION Effective geometric and functional evaluation of initial remodeling due to hemodynamic stress is important according to both human and animal data. These findings possibly contribute to early recognition of adaptive phase of hypertensive remodeling and more effective management in a timely fashion.
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Affiliation(s)
- Fatih Yalçin
- Corresponding author. Department of Medicine, University of California at San Francisco, Cardiology UCSF Health, 505 Parnassus Avenue, Rm M314AUCSF Box 0214, San Francisco, CA, 94117, USA.
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Loncaric F, Marciniak M, Nunno L, Mimbrero M, Fernandes JF, Fabijanovic D, Sanchis L, Doltra A, Montserrat S, Cikes M, Lamata P, Bijnens B, Sitges M. Distribution of myocardial work in arterial hypertension: insights from non-invasive left ventricular pressure-strain relations. Int J Cardiovasc Imaging 2021; 37:145-154. [PMID: 32789553 DOI: 10.1007/s10554-020-01969-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
A index of non-invasive myocardial work (MWI) can account for pressure during the assessment of cardiac function, potentially separating the influence of loading conditions from the influence of the underlying tissue remodelling. The aim is to assess LV function accounted for loading and explore hypertensive MWI distribution by comparing healthy individuals to hypertensive patients without and with localized basal septal hypertrophy (BSH). An echocardiogram was performed in 170 hypertensive patients and 20 healthy individuals. BSH was defined by a basal-to-mid septal wall thickness ratio ≥ 1.4. LV speckle-tracking was performed, and the MWI calculated globally and regionally for the apical, mid and basal regions. An apex-to-base gradient, seen in regional strain values, was preserved in the distribution of myocardial work, with the apical region compensating for the impairment of the basal segments. This functional redistribution was further pronounced in patients with localized BSH. In these patients, segmental MWI analysis revealed underlying impairment of regional work unrelated to acute loading conditions. Non-invasive MWI analysis offers the possibility to compare LV function regardless of blood pressure at the time of observation. Changes in MWI distribution can be seen in hypertension unrelated to the load-dependency of strain. Accentuated functional changes affirm the role of BSH as an echocardiographic marker in hypertension.
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Affiliation(s)
- Filip Loncaric
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain.
| | - Maciej Marciniak
- Department of Biomedical Engineering, Kings College London, London, UK
| | - Loredana Nunno
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Maria Mimbrero
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Joao F Fernandes
- Department of Biomedical Engineering, Kings College London, London, UK
| | - Dora Fabijanovic
- University Hospital Centre Zagreb, Department for Cardiovascular Diseases and University of Zagreb School of Medicine, Zagreb, Croatia
| | - Laura Sanchis
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Adelina Doltra
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
| | - Silvia Montserrat
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III (CB16/11/00354); CERCA Programme / Generalitat de Catalunya, Madrid, Spain
| | - Maja Cikes
- University Hospital Centre Zagreb, Department for Cardiovascular Diseases and University of Zagreb School of Medicine, Zagreb, Croatia
| | - Pablo Lamata
- Department of Biomedical Engineering, Kings College London, London, UK
| | - Bart Bijnens
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- La Institució Catalana de Recerca i Estudis Avançats, (ICREA), Barcelona, Spain
| | - Marta Sitges
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III (CB16/11/00354); CERCA Programme / Generalitat de Catalunya, Madrid, Spain
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