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Assessment of Left Ventricular Myocardial Work Performance in Patients with Essential Hypertension
Session:
SESSÃO DE POSTERS 38 - ANÁLISE DE DEFORMAÇÃO MIOCÁRDICA
Speaker:
Luís Miguel Cardoso Cotrim
Congress:
CPC 2025
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Cartazes
FP Number:
---
Authors:
Luís Cotrim; Rita Santos; António Carvalho; Lígia Mendes
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Background</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Myocardial work (MW) is an advanced echocardiographic tool that evaluates left ventricular (LV) function by integrating afterload and myocardial deformation. Hypertension (HTN), a major cardiovascular risk factor, is associated with LV remodeling and dysfunction. This study aimed to characterize global MW indices in hypertensive and non-hypertensive individuals.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">A retrospective, single-center study was conducted, including patients without known cardiovascular disease who underwent MW assessment between January 2022 and November 2024. Echocardiographic parameters, including global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE), were analyzed. Patients were stratified by hypertension status (HTN diagnosis and elevated blood pressure [BP] during the exam). LV remodeling patterns (concentric remodeling [CR] vs. left ventricular hypertrophy [LVH]) were also evaluated. Multivariate analyses adjusted for age and sex identified predictors of MW parameters.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Among 822 patients (43.7% with HTN), hypertensive individuals exhibited more cardiovascular risk factors, higher resting BP, greater LV remodeling (CR and LVH), and larger left atrial volumes (all p<0.05). MW parameters were comparable between hypertensive and non-hypertensive groups (p>0.05), and LV remodeling patterns did not significantly influence MW indices. However, patients with elevated resting BP (≥140/90 mmHg) demonstrated significantly higher GWI, GCW, and GWW (p<0.05). Multivariate analysis identified elevated resting BP as the sole independent predictor of MW parameters, strongly influencing GWI, GCW, and GWW.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">In this unselected cohort, MW indices derived from deformation imaging were similar between hypertensive and non-hypertensive patients and across LV remodeling patterns. However, elevated resting BP was independently associated with increased myocardial workload, reflected by higher GWI, GCW, and GWW, underscoring the augmented afterload on the LV. These findings emphasize the importance of BP control to mitigate excessive myocardial strain and preserve LV performance.</span></span></p> <p style="text-align:justify"> </p>
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