Evaluation of regional myocardial dynamics at physical stress in hypertensive patients

Background Left ventricular hypertrophy (LVH) in adaptive phase is related to sympathetic overdrive and hyperdynamic tissue could be detected differently from cardiomyopathies. This study aimed to demonstrate the effect of physical stress on myocardial tissue velocities and left ventricular outflow tract (LVOT) velocity and additionally correlation between LVOT velocity and Doppler tissue imaging (DTI) parameters in hypertensive patients. Methods Sixty patients (mean age: 52 ± 9 years) with essential hypertension underwent echocardiographic examination both at rest and physical stress (bicycle ergometry). The patients were separated into two groups according to presence LVH (45 in LVH group, 15 in non‐LVH group). In addition to the conventional echo, regional myocardial functions by DTI and LVOT velocities by pulsed Doppler were detected. Results LVOT velocities both at rest and stress were similar between two groups. Myocardial systolic velocity at basal septum s' was 7.3 ± 1.2 cm/s in LVH group and 8.1 ± 2.0 cm/s in non‐LVH group ( p :0.04) at rest, but similar between two groups at stress (9.2 ± 2.2 cm/s vs. 8.8 ± 1.0 cm/s, non‐significant). LVOT velocity was correlated with septal s' at rest ( r :0.371, p :0.03) and stress ( r :0.294, p :0.04). Conclusions Correlation between stress‐related regional tissue dynamics and LVOT velocities demonstrates the response of myocardial tissue to stress in adaptive phase of LV remodeling of hypertensive LVH. ClinicalTrials.gov Identifier: NCT01442116.