Department of Cardiology, University Hospital "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
Department of Medicine and Surgery, University Milano-Bicocca, Milano, Italy.
J Hum Hypertens. 2022 Jun;36(6):524-530. doi: 10.1038/s41371-021-00543-2. Epub 2021 May 5.
We sought to investigate echocardiography-derived myocardial work in hypertensive patients with different left ventricular (LV) geometric patterns. This cross-sectional study included 211 hypertensive patients (74 with normal LV geometry, 53 with concentric remodeling, 46 with eccentric LV hypertrophy (LVH) and 38 with concentric LVH) who underwent complete two-dimensional echocardiographic examination including two-dimensional speckle-tracking echocardiography. Pressure-strain curve was used to determine parameters of myocardial work. Our findings showed that multidirectional LV strain was lower in patients with eccentric and concentric LVH than in those with normal LV geometry and concentric remodeling. Global myocardial work index and global constructive work were higher in patients with eccentric and concentric LVH than in those with normal LV geometry and concentric remodeling. Global wasted work and global efficacy work were similar between groups with different LV geometry. E/e' and LV mass index were associated with global myocardial work index and global constructive work independently of clinical and echocardiographic parameters. In conclusion, myocardial work was higher in patients with eccentric and concentric LVH than in patients with normal LV geometry and concentric remodeling. Increased blood pressure in patients with concentric LVH in comparison with other LV geometric patterns has significant impact on the final result. LV geometry has significant impact on myocardial work in hypertensive patients.
我们旨在研究不同左心室（LV）几何形态的高血压患者的超声心动图衍生心肌做功。这项横断面研究纳入了 211 例高血压患者（74 例为正常 LV 几何形态，53 例为同心重构，46 例为偏心 LV 肥厚（LVH），38 例为同心 LVH），所有患者均接受了二维超声心动图检查，包括二维斑点追踪超声心动图。压力-应变曲线用于确定心肌做功参数。我们的研究结果显示，偏心性和同心性 LVH 患者的多方向 LV 应变低于正常 LV 几何形态和同心性重构患者。偏心性和同心性 LVH 患者的整体心肌做功指数和整体构建性功高于正常 LV 几何形态和同心性重构患者。不同 LV 几何形态患者之间的整体无效功和整体效能功相似。E/e'和 LV 质量指数与整体心肌做功指数和整体构建性功独立于临床和超声心动图参数相关。总之，偏心性和同心性 LVH 患者的心肌做功高于正常 LV 几何形态和同心性重构患者。与其他 LV 几何形态相比，同心性 LVH 患者的血压升高对最终结果有显著影响。LV 几何形态对高血压患者的心肌做功有显著影响。
