Abstract 12513: Comparison of Global Myocardial Function With 2 Types of Pressure-Overload Left Ventricular Hypertrophy Using Two-Dimentional Speckle-Tracking Echocardiography
Introduction: Left ventricular hypertrophy (LVH) secondary to hypertension and aortic stenosis (AS) are often considered together to be pressure overload hypertrophy. Comparisons of myocardial function by the 2 most common causes of LVH are limited. The global LV afterload that may be assessed by valvuloarterial impedance plays a detrimental effect on LV systolic function.
Hypothesis: We hypothesized that important differences may exist in the myocardial function with these 2 origins of pressure-overload LVH.
Methods: Global LV longitudinal strain (GLS) were measured using speckle-tracking echocardiography in 38 hypertensive LVH (H-LVH) patients and 36 patients with severe AS and preserved LV ejection fraction. To estimate the global LV afterload, we calculated the valvuloarterial impedance (Zva) as the sum of the systolic arterial pressure and the mean transvalvular pressure gradient divided by the stroke volume index.
Results: The patients were divided into two groups according to the level of Zva: low Zva (Zva<3mmHg ml/m2, n=25) and high Zva (Zva≥3mmHg ml/m2, n=49). GLS was reduced in the high Zva group (p<0.05). The patients in the high Zva group were divided into two subgroups: AS group (n=28) and H-LVH group (n=21). Systolic blood pressure was higher in the H-LVH group than in the AS group (p<0.0001). However, LV mass index and LV ejection fraction were not significantly differences. GLS was significantly reduced in the AS group (p<0.0001). In the AS group, GLS was significantly correlated with Zva (r=0.44). However, there was no correlation between GLS and mean transaortic pressure gradient.
Conclusions: Despite of similar global LV afterload and LV hypertrophy, myocardial LV longitudinal systolic function is impaired in patients with severe AS compared with H-LVH patients. However, there is no correlation between AS severity and LV longitudinal deformation. The magnitude of the global LV afterload as reflected by Zva is a powerful determinant of altered LV longitudinal deformation in severe AS patinets with preserved LV ejection fraction.
Author Disclosures: Y. Ohara: None. Y. Tsuda: None. Y. Fukuoka: None. A. Furukawa: None. S. Hosogi: None. K. Yamamoto: None.
- © 2016 by American Heart Association, Inc.