Blood Immune Cell Alterations in Patients with Hypertensive Left Ventricular Hypertrophy and Heart Failure with Preserved Ejection Fraction

Figure 1. An example of (a) LA reservoir strain (LASr), and (b) LV global longitudinal strain during early diastole (SRE) and during the isovolumic relaxation period (SRIVR) in a patient with HFpEF. LA strain was determined as the average value of the longitudinal positive strain peak under LA relaxation from all six segments of the LA in the apical 4-chamber view, using the onset of the QRS as the referent point. The white dotted curve represents the average value of LA strain from all analyzed LA segments. SRE and SRIVR were determined as the average values of the longitudinal positive strain rate peak during LV early diastole and isovolumic relaxation period, respectively, from all LV segments in the apical 4-chamber view. Different color lines represent strain rate curves of individual LV segments. The white dotted curve corresponds to the average value of LV strain rate from all six analyzed LV segments. LA, left atrial; LV, left ventricular.

Figure 2. An example of myocardial work analysis in a patient with HFpEF. The LV pressure-strain loop is presented in a 17-segment myocardial work bull’s-eye plot; the proportion of constructive (green) and wasted work (blue) and calculations are presented. BP, blood pressure; GWE, global myocardial work efficiency; GWI, global myocardial work index; GLS, global longitudinal strain; GCW, global constructive work; GWW, global wasted work.

Figure 3. The total number of (a) regulatory T-cells (Treg), (b) activated T-helper cells (Th-act), and (c) their ratio in patients with asymptomatic LVH vs. those with HFpEF. Orange dots correspond to the values of the variable in individual patients.

Figure 4. Ratio of regulatory T-cells to activated T-helper cells (Treg/Th-act) and functional severity in patients with HFpEF. Results were stratified by the severity of heart failure expressed by the New York Heart Association (NYHA) functional class and were compared via the Kruksal–Wallis ANOVA rank analysis of variance. Orange dots correspond to the values of the variable in individual patients.

Figure 5. Correlations between echocardiographic parameters of LV diastolic function/filling pressure (e′ velocity and E/e′ ratio) both during rest (a,c) and at the peak of exercise (b,d), and Treg/Th-act ratio in patients with LVH and HFpEF. E, early inflow velocity; e′, averaged annulus relaxation velocity; Th-act, activated T-helper cells; Treg, regulatory T-cells. Black dots correspond to the values in individual patients.

Figure 6. (a) The regulatory T-cell/activated T-helper cell ratio and (b) intermediate monocyte blood count in patients with HFpEF and type 2 diabetes mellitus (T2DM) vs. patients with HFpEF alone (b). Orange dots correspond to the values of the variable in individual patients.