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Echocardiography in Hypertension

  • Azin Alizadehasl
  • Anita Sadeghpour
Chapter

Abstract

Hypertension (HTN) is a heterogeneous disease with a number of well-defined as well as supposed reasons. HTN is a main risk factor for stroke and all cardiovascular disorders and is, therefore, associated with significant morbidity and mortality rates. The key role of echocardiography in the management of hypertension is the evaluation of left ventricular hypertrophy (LVH) and left ventricular mass (LVM). Indeed, LVH, LV diastolic dysfunction, and left atrial (LA) enlargement are specific signs of hypertensive heart disease (HHD).

The development of Doppler echocardiography, strain imaging, and three-dimensional echocardiography (3DE) has offered new approaches regarding perceptions in pathophysiology and also clinical implications in hypertensive patients.

Keywords

Echocardiography Hypertensive heart disease LA volume Left ventricular hypertrophy LV mass Relative wall thickness (RWT) Concentric hypertrophy Eccentric hypertrophy Concentric remodeling 

Abbreviations

3DE

Three-dimensional echocardiography

ACC

American college of cardiology

ASE

American society of echocardiography

AUC

Appropriate use criteria

CMR

Cardiac magnetic resonance

EACVI

European association of cardiovascular imaging

HHD

Hypertensive heart disease

HTN

Hypertension

IVS

Interventricular septum

JNC

Joint national committee

LA

Left atrial

LVH

Left ventricular hypertrophy

LVM

Left ventricular mass

PW

Posterior wall

RWT

Relative wall thickness

TTE

Transthoracic echocardiography

References

  1. 1.
    Cuspidi C, Meani S, Valerio C, et al. Ambulatory blood pressure, target organ damage and aortic root size in never-treated essential hypertensive patients. J Hum Hypertens. 2007;21:531–8.CrossRefGoogle Scholar
  2. 2.
    Cortigiani L, Bigi R, Landi P, Bovenzi F, Picano E, Sicari R. Prognostic implication of stress echocardiography in 6214 hypertensive and 5328 normotensive patients. Eur Heart J. 2011;32:1509–18.CrossRefGoogle Scholar
  3. 3.
    Cameli M, Lisi M, Righini FM, Massoni A, Mondillo S. LV remodeling and torsion dynamics in hypertensive patients. Int J Cardiovasc Imaging. 2012;29(1):79–86. [Epub ahead of print].CrossRefGoogle Scholar
  4. 4.
    Kim MN, Park SM, Shim WJ, Kim YH, Kim SA, Cho DH. The relationship between aortic stiffness and LV dyssynchrony in hypertensive patients with preserved LV systolic function. Clin Exp Hypertens. 2012;34:410–6.CrossRefGoogle Scholar
  5. 5.
    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined LV mass in the Framingham heart study. N Engl J Med. 1990;322:1561–6.CrossRefGoogle Scholar
  6. 6.
    Cuspidi C, Ambrosioni E, Mancia G, Pessina AC, Trimarco B, Zanchetti A. Role of echocardiography and carotid ultrasonography in stratifying risk in patients with essential HTN: the assessment of prognostic risk observational survey. J Hypertens. 2002;20:1307–14.CrossRefGoogle Scholar
  7. 7.
    Ilercil A, O’Grady MJ, Roman MJ, et al. Reference values for echocardiographic measurements in urban and rural populations of differing ethnicity: the strong heart study. J Am Soc Echocardiogr. 2001;14:601–11.CrossRefGoogle Scholar
  8. 8.
    Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of leftventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens. 2012;26:343–9.CrossRefGoogle Scholar
  9. 9.
    Dianzumba SB, DiPette D, Joyner CR, Townsend R, Weber E, Mauro K, et al. Left ventricular function in mild hypertension after adrenergic blockade. Hypertension. 1988;11:198–02.CrossRefGoogle Scholar
  10. 10.
    American College of Cardiology Foundation Appropriate Use CriteriaTask Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, et al. J Am Coll Cardiol. 2011;57:1126–66.Google Scholar
  11. 11.
    Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7:79–108.CrossRefGoogle Scholar
  12. 12.
    Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of LV hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57:450–8.CrossRefGoogle Scholar
  13. 13.
    Marwick TH, Gillebert TC, Aurigemma G, Chirinos J, Derumeaux G, Galderisi M, Gottdiener J, Haluska B, Ofili E, Segers P, Senior R, Tapp RJ, Zamorano JL. Recommendations on the use of echocardiography in adult HTN: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). J Am Soc Echocardiogr. 2015(28):727–54.Google Scholar
  14. 14.
    Karabinos I, Grassos C, Kostaki P, Kranidis A. Echocardiography in the evaluation of a hypertensive patient: an invaluable tool or simply following the routine? Hell J Cardiol. 2013;54:47–57.Google Scholar
  15. 15.
    Yuda S, Shimamoto K, Watanabe N. Clinical applications of strain rate imaging for evaluation of left atrial function. Rinsho Byori. 2010;58:799–808.PubMedGoogle Scholar
  16. 16.
    Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251–9.CrossRefGoogle Scholar
  17. 17.
    Devereux RB, Roman MJ, Palmieri V, et al. Left ventricular wall stresses and wall stress-mass-heart rate products in hypertensive patients with electrocardiographic left ventricular hypertrophy: the LIFE study. Losartan intervention for endpoint reduction in hypertension. J Hypertens. 2000;18:1129–38.CrossRefGoogle Scholar
  18. 18.
    Ruan Q, Nagueh SF. Usefulness of isovolumic and systolic ejection signals by tissue Doppler for the assessment of left ventricular systolic function in ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 2006;97:872–5.CrossRefGoogle Scholar
  19. 19.
    Fici F, Ural D, Tayfun S, et al. Left ventricular diastolic dysfunction in newly diagnosed untreated hypertensive patients. Blood Press. 2012;21:331–7.CrossRefGoogle Scholar
  20. 20.
    Bella JN, Palmieri V, Roman MJ, et al. Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the strong heart study. Circulation. 2002;105:1928–33.CrossRefGoogle Scholar
  21. 21.
    Lang RM, Badano L, Afilalo J, Chamber Quantification Writing Group, American Society of Echocardiography’s Guidelines, Standards Committee, European Association of Echocardiography. Recommendations for cardiac chamber quantification by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.CrossRefGoogle Scholar
  22. 22.
    Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, et al. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol. 2006;47:1018–23.CrossRefGoogle Scholar
  23. 23.
    Mornoş C, Ruşinaru D, Manolis AJ, Zacharopoulou I, Pittaras A, Ionac A. The value of a new speckle tracking index including left ventricular global longitudinal strain and torsion in patients with dilated cardiomyopathy. Hell J Cardiol. 2011;52:299–306.Google Scholar
  24. 24.
    Feigenbaum H, Mastouri R, Sawada S. A practical approach to using strain echocardiography to evaluate the left ventricle. Circ J. 2012;76:1550–5.CrossRefGoogle Scholar
  25. 25.
    Imbalzano E, Zito C, Carerj S, et al. Left ventricular function in hypertension: new insight by speckle tracking echocardiography. Echocardiography. 2011;28:649–57.CrossRefGoogle Scholar
  26. 26.
    Kouzu H, Yuda S, Muranaka A, et al. Left ventricular hypertrophy causes different changes in longitudinal, radial, and circumferential mechanics in patients with hypertension: a two-dimensional speckle tracking study. J Am Soc Echocardiogr. 2011;24:192–9.CrossRefGoogle Scholar
  27. 27.
    Galderisi M, Lomoriello VS, Santoro A, et al. Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study. J Am Soc Echocardiogr. 2010;23:1190–8.CrossRefGoogle Scholar
  28. 28.
    Jenkins C, Moir S, Chan J, Rakhit D, Haluska B, Marwick TH. Left ventricular volume measurement with echocardiography: a comparison of left ventricular opacification, three-dimensional echocardiography, or both with magnetic resonance imaging. Eur Heart J. 2009;30:98–106.CrossRefGoogle Scholar
  29. 29.
    Dorosz JL, Lezotte DC, Weitzenkamp DA, Allen LA, Salcedo EE. Performance of 3-dimensional echocardiography in measuring left ventricular volumes and ejection fraction: a systematic review and meta-analysis. J Am Coll Cardiol. 2012;59:1799–808.CrossRefGoogle Scholar
  30. 30.
    Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, et al. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr. 2012;25:3–46.CrossRefGoogle Scholar
  31. 31.
    Takeuchi M, Nishikage T, Mor-Avi V, Sugeng L, Weinert L, Nakai H, et al. Measurement of left ventricular mass by real-time three-dimensional echocardiography: validation against magnetic resonance and comparison with two-dimensional and M-mode measurements. J Am Soc Echocardiogr. 2008;21:1001–5.CrossRefGoogle Scholar
  32. 32.
    van den Bosch AE, Robbers-Visser D, Krenning BJ, McGhie JS, Helbing WA, Meijboom FJ, et al. Comparison of real-time three-dimensional echocardiography to magnetic resonance imaging for assessment of left ventricular mass. Am J Cardiol. 2006;97:113–7.CrossRefGoogle Scholar
  33. 33.
    Shimada YJ, Shiota T. Meta-analysis of accuracy of left ventricular mass measurement by three-dimensional echocardiography. Am J Cardiol. 2012;110:445–52.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Azin Alizadehasl
    • 1
  • Anita Sadeghpour
    • 2
  1. 1.Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran
  2. 2.Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran

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