Loncaric Filip, Nunno Loredana, Mimbrero Maria, Marciniak Maciej, Fernandes Joao Filipe, Tirapu Laia, Fabijanovic Dora, Sanchis Laura, Doltra Adelina, Cikes Maja, Lamata Pablo, Bijnens Bart, Sitges Marta
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Cardiovascular Institute, Hospital Clínic and Universitat de Barcelona, Barcelona, Spain.
Am J Cardiol. 2020 May 1;125(9):1339-1346. doi: 10.1016/j.amjcard.2020.01.045. Epub 2020 Feb 8.
Basal septal hypertrophy (BSH) is commonly seen in patients with systemic hypertension and has been associated with increased afterload. The impact of localized hypertrophy on left ventricular (LV) and left atrial (LA) function is still unclear. Our aim is to investigate if BSH is a marker of a more pronounced impact of hypertension on cardiac function in the early stages of hypertensive heart disease. An echocardiogram was performed in 163 well-controlled hypertensive patients and 22 healthy individuals. BSH was defined by a basal-to-mid septal thickness ratio ≥1.4. LV dimensions and mass were evaluated. LV global and regional deformation was assessed by 2-dimensional (2D) speckle tracking echocardiography, and LV diastolic function by 2D and Doppler imaging. LA function was evaluated with phasic volume indices calculated from 2D and 3-dimensional volumes, as well as speckle tracking echocardiography. The population was 54% men, mean age 57 (53 to 60) years. BSH was seen in 20% (n = 32) of the hypertensive cohort. Patients with BSH showed decreased regional LV systolic deformation, impaired LV relaxation with a higher proportion of indeterminate LV diastolic function, and LA functional impairment defined by a reduction of reservoir strain and a change in LA functional dynamics. In conclusion, in well-controlled hypertension impairment of LV and LA function is present in patients with early LV remodeling and localized hypertrophy. BSH might be useful as an early marker of the burden of hypertensive heart disease.
基底间隔肥厚（BSH）常见于系统性高血压患者，且与后负荷增加有关。局部肥厚对左心室（LV）和左心房（LA）功能的影响仍不明确。我们的目的是研究BSH是否是高血压性心脏病早期高血压对心脏功能更显著影响的一个标志。对163例血压控制良好的高血压患者和22名健康个体进行了超声心动图检查。BSH定义为基底至中间隔厚度比≥1.4。评估了左心室尺寸和质量。通过二维（2D）斑点追踪超声心动图评估左心室整体和局部变形，通过二维和多普勒成像评估左心室舒张功能。通过从二维和三维容积计算出的相位容积指数以及斑点追踪超声心动图评估左心房功能。研究人群中男性占54%，平均年龄57（53至60）岁。高血压队列中有20%（n = 32）出现BSH。患有BSH的患者表现出左心室局部收缩变形降低、左心室舒张功能受损且不确定左心室舒张功能的比例更高，以及左心房功能受损，表现为储存应变降低和左心房功能动力学改变。总之，在血压控制良好的高血压患者中，早期左心室重塑和局部肥厚的患者存在左心室和左心房功能受损。BSH可能作为高血压性心脏病负担的早期标志物。
