Ultrasound tissue characterization showed hypertensive LVH patients with vs without abnormal filling differed significantly in cyclic variation (P<0.01) and calibrated integrated backscatter (P<0.05).
Observational (n=113)
Does ultrasound tissue characterization and strain imaging detect myocardial structural and functional abnormalities in hypertensive patients with LVH?
Ultrasound tissue characterization using integrated backscatter can detect structural myocardial abnormalities that contribute to abnormal LV filling in hypertensive patients with LVH, potentially serving as an early sign of LV damage.
p-value: p=<0.01
Abnormal left ventricular (LV) filling is common, but not universal, in hypertensive LV hypertrophy (LVH). We sought to elucidate the relative contributions of myocardial structural changes, loading and hypertrophy to LV dysfunction in 113 patients: 85 with hypertensive LVH and 28 controls without LVH and with normal filling. Patients with normal dobutamine stress echocardiography and no history of coronary artery disease were selected, in order to exclude a contribution from ischaemia or scar. Abnormal LV filling was identified in 65 LVH patients, based on Doppler measurement of transmitral filling and annular velocities. All patients underwent grey-scale and colour tissue Doppler imaging from three apical views, which were stored and analysed off line. Integrated backscatter (IB) and strain rate imaging were used to detect changes in structure and function; average cyclic variation of IB, strain rate and peak systolic strain were calculated by averaging each segment. Calibrated IB intensity, corrected for pericardial IB intensity, was measured in the septum and posterior wall from the parasternal long-axis view. Patients with LVH differed significantly from controls with respect to all backscatter and strain parameters, irrespective of the presence or absence of abnormal LV filling. LVH patients with and without abnormal LV filling differed with regard to age, LV mass and incidence of diabetes mellitus, but also showed significant differences in cyclic variation (P<0.01), calibrated IB in the posterior wall (P<0.05) and strain rate (P<0.01), although blood pressure, heart rate and LV systolic function were similar. Multivariate logistic regression analysis demonstrated that age, LV mass index and calibrated IB in the posterior wall were independent determinants of abnormal LV filling in patients with LVH. Thus structural and functional abnormalities can be detected in hypertensive patients with LVH with and without abnormal LV filling. In addition to age and LVH, structural (not functional) abnormalities are likely to contribute to abnormal LV filling, and may be an early sign of LV damage. IB is useful for the detection of myocardial abnormalities in patients with hypertensive LVH.
Yuda et al. (Mon,) conducted a observational in Hypertensive left ventricular hypertrophy (n=113). Ultrasound tissue characterization and strain imaging vs. Controls without LVH and normal filling was evaluated on Differences in cyclic variation, calibrated integrated backscatter, and strain rate (p=<0.01). Ultrasound tissue characterization showed hypertensive LVH patients with vs without abnormal filling differed significantly in cyclic variation (P<0.01) and calibrated integrated backscatter (P<0.05).