Key result
Elevated resting blood pressure linked to increased global workload indices, indicating greater myocardial strain.
Why the study?
Hypertension is associated with LV remodeling and dysfunction, but characterization of global myocardial work indices integrating afterload and myocardial deformation in hypertensive versus non-hypertensive individuals was needed.
Does hypertension or elevated resting blood pressure alter global myocardial work indices in patients without known cardiovascular disease?
Observational (n=822)
No
Does hypertension or elevated resting blood pressure alter global myocardial work indices in patients without known cardiovascular disease?
Elevated resting blood pressure, rather than a historical diagnosis of hypertension or left ventricular remodeling, is independently associated with increased myocardial workload as measured by echocardiographic myocardial work indices.
Answers are grounded in this paper and cite their sources.
Current BP elevation—not HTN history—drives higher MW; leaves open whether indices add prognostic value beyond BP.
Background Myocardial work (MW) is an advanced echocardiographic tool that evaluates left ventricular (LV) function by integrating afterload and myocardial deformation. Hypertension (HTN), a major cardiovascular risk factor, is associated with LV remodeling and dysfunction. This study aimed to characterize global MW indices in hypertensive and non-hypertensive individuals. Methods A retrospective, single-center study was conducted, including patients without known cardiovascular disease who underwent MW assessment between January 2022 and November 2024. Echocardiographic parameters, including global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE), were analyzed. Patients were stratified by hypertension status (HTN diagnosis and elevated blood pressure [BP] during the exam). LV remodeling patterns (concentric remodeling [CR] vs. left ventricular hypertrophy [LVH]) were also evaluated. Multivariate analyses adjusted for age and sex identified predictors of MW parameters. Results Among 822 patients (43.7% with HTN), hypertensive individuals exhibited more cardiovascular risk factors, higher resting BP, greater LV remodeling (CR and LVH), and larger left atrial volumes (all p<0.05) (Table 1). MW parameters were comparable between hypertensive and non-hypertensive groups (p>0.05), and LV remodeling patterns did not significantly influence MW indices. However, patients with elevated resting BP (≥140/90 mmHg) demonstrated significantly higher GWI, GCW, and GWW (p<0.05) (Table 2). Multivariate analysis identified elevated resting BP as the sole independent predictor of MW parameters, strongly influencing GWI, GCW, and GWW. Conclusion In this unselected cohort, MW indices derived from deformation imaging were similar between hypertensive and non-hypertensive patients and across LV remodeling patterns. However, elevated resting BP was independently associated with increased myocardial workload, reflected by higher GWI, GCW, and GWW, underscoring the augmented afterload on the LV. These findings emphasize the importance of BP control to mitigate excessive myocardial strain and preserve LV performance.
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Cotrim et al. (2026) conducted an observational in Hypertension (n=822). Elevated resting blood pressure (≥140/90 mmHg) vs. Normal resting blood pressure was evaluated on Global myocardial work indices (GWI, GCW, GWW) (p=<0.05). Elevated resting blood pressure (≥140/90 mmHg) was independently associated with increased myocardial workload, reflected by significantly higher global work index, constructive work, and wasted work (p<0.05).
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