The relationship between left ventricular wall thickness, myocardial shortening and ejection fraction in hypertensive heart disease: insights from cardiac magnetic resonance: LVH independently augments EF in hypertension

Jonathan C L Rodrigues, Stephen Rohan, Amardeep Ghosh Dastidar, Adam Trickey, Gergely Szantho, Laura E K Ratcliffe, Amy E Burchell, Emma C Hart, Chiara Bucciarelli-Ducci, Mark C K Hamilton, Angus K Nightingale, Julian F R Paton, Nathan E Manghat, David H MacIver

Research output: Contribution to journalArticle (Academic Journal)peer-review

19 Citations (Scopus)
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Abstract

Hypertensive heart disease is often associated with a preserved left ventricular ejection fraction despite impaired myocardial shortening. The authors investigated this paradox in 55 hypertensive patients (52±13 years, 58% male) and 32 age- and sex-matched normotensive control patients (49±11 years, 56% male) who underwent cardiac magnetic resonance imaging at 1.5T. Long-axis shortening (R=0.62), midwall fractional shortening (R=0.68), and radial strain (R=0.48) all decreased (P<.001) as end-diastolic wall thickness increased. However, absolute wall thickening (defined as end-systolic minus end-diastolic wall thickness) was maintained, despite the reduced myocardial shortening. Absolute wall thickening correlated with ejection fraction (R=0.70, P<.0001). In multiple linear regression analysis, increasing wall thickness by 1 mm independently increased ejection fraction by 3.43 percentage points (adjusted β-coefficient: 3.43 [2.60–4.26], P<.0001). Increasing end-diastolic wall thickness augments ejection fraction through preservation of absolute wall thickening. Left ventricular ejection fraction should not be used in patients with hypertensive heart disease without correction for degree of hypertrophy.
Original languageEnglish
Pages (from-to)1119-1127
Number of pages9
JournalJournal of Clinical Hypertension
Volume18
Issue number11
Early online date17 Jun 2016
DOIs
Publication statusPublished - Nov 2016

Structured keywords

  • CRICBristol
  • Bristol Heart Institute

Keywords

  • Left ventricular hypertrophy
  • Pathophysiology
  • Heart Failure
  • Hypertension - general

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