Myocardial strain characterization in different left ventricular adaptative responses to high blood pressure: a study based on 3D-wall motion tracking analysis.

ABSTRACT

BACKGROUND: High blood pressure increases left ventricular (LV) after-load. Furthermore, LV response to that high blood pressure varies among different subjects. Nevertheless, myocardial deformation behavior in these different adaptative responses has not been analyzed until now. METHODS: Prospective study in which 66 consecutive hypertensive patients were enrolled in between May and August 2009. Every patient underwent a standard echocardiographic study and a three-dimensional-wall motion tracking (3D-WMT) study. The patients were classified according to parameters derived from echocardiography in four different groups normal geometry, concentric remodelling, concentric hypertrophy, and eccentric hypertrophy. RESULTS: Mean age was 68 years (57-74.25; 51.5% male). Comparing the four groups, significant differences were found for the five 3D-WMT-derived parameters. When patients were compared with hypertensive patients with normal geometry, our finding show that (a) LV average torsion is the only impaired parameter that is found in the LV concentric remodelling group (P < 0.05 vs. group 1); (b) there is a trend for an increase (P = 0.055) in LV average radial strain in the group with concentric hypertrophy and this increase is accompanied by a significant decrease in the remaining studied parameters (P < 0.05); and (c) in the LV eccentric hypertrophy group, there is a significant impairment in all the studied parameters (P < 0.05). CONCLUSIONS: LV adaptative response to hypertension is accompanied by a modification or even impairment, in LV myocardial deformation evaluated by 3D-WMT. This assessment might be useful to detect early and subtle deformation impairments in hypertensive patients and it could help optimize their clinical management.