Key result
In patients with essential hypertension, the degree of mitral regurgitation was independently correlated with worse global longitudinal peak strain.
Why the study?
Mitral regurgitation is commonly seen in hypertension, but its effect on left ventricular strain impairment and factors independently impacting LV global peak strain remained to be evaluated.
Does mitral regurgitation exacerbate left ventricular strain impairment in patients with essential hypertension?
Cross-Sectional (n=245)
No
Does mitral regurgitation exacerbate left ventricular strain impairment in patients with essential hypertension?
Mitral regurgitation additively worsens left ventricular strain impairment in patients with essential hypertension, with the degree of impairment correlating with regurgitation severity.
Answers are grounded in this paper and cite their sources.
MR severity was associated with reduced GRS in hypertensive patients; hypothesis-generating and should not yet change practice.
Objectives Hypertension is one of the leading risk factors for cardiovascular disease. Mitral regurgitation (MR) is a heart valve disease commonly seen in hypertensive cases. This study aims to assess the effect of MR on left ventricle (LV) strain impairment among essential hypertensive cases and determine factors that independently impact the global peak strain of the LV. Materials and methods We enrolled 184 essential hypertensive patients, of which 53 were patients with MR [HTN (MR +) group] and 131 were without MR [HTN (MR−) group]. Another group of 61 age-and gender-matched controls was also included in the study. All participants had received cardiac magnetic resonance examination. The HTN (MR +) group was classified into three subsets based on regurgitation fraction, comprising mild MR ( n = 22), moderate MR ( n = 19), and severe MR ( n = 12). We compared the LV function and strain parameters across different groups. Moreover, we performed multivariate linear regression to determine the independent factors affecting LV global radial peak strain (GRS), circumferential peak strain (GCS), and global longitudinal peak strain (GLS). Results HTN (MR−) cases exhibited markedly impaired GLS and peak diastolic strain rate (PDSR) but preserved LV ejection fraction (LVEF) compared to the controls. However, HTN (MR +) patients showed a decrease in LVEF and further deteriorated GRS, GCS, GLS, PDSR, and the peak systolic strain rate (PSSR) compared to the HTN (MR−) group and controls. With increasing degrees of regurgitation, the LV strain parameters were gradually reduced in HTN (MR +) patients. Even the mild MR group showed impaired GCS, GLS, PDSR, and PSSR compared to the HTN (MR−) group. Multiple regression analyses indicated that the degree of regurgitation was independently associated with GRS (β = -0.348), GCS (β = -0.339), and GLS (β = -0.344) in HTN (MR +) patients. Conclusion GLS was significantly impaired in HTN (MR−) patients. MR may further exacerbate the deterioration of LV strain among essential hypertensive cases. Besides, the degree of regurgitation was independently correlated with GRS, GCS, and GLS in HTN (MR +) patients.
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Tang et al. (2022) conducted a cross-sectional in Essential hypertension with or without mitral regurgitation (n=245). Mitral regurgitation vs. Hypertension without mitral regurgitation and healthy controls was evaluated on Global longitudinal peak strain (GLS) (β = -0.344, p=0.018). In patients with essential hypertension, the degree of mitral regurgitation was independently correlated with worse global longitudinal peak strain.
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