Evaluation of Segmental Myocardial Work and Exercise Tolerance in Hypertension Patients With Left Ventricular Remodeling Through Stress Echocardiography

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-03-21 DOI:10.1111/echo.70093

Qingfeng Zhang, Yi Wang, Hongmei Zhang, Geqi Ding, Lixue Yin

{"title":"Evaluation of Segmental Myocardial Work and Exercise Tolerance in Hypertension Patients With Left Ventricular Remodeling Through Stress Echocardiography","authors":"Qingfeng Zhang, Yi Wang, Hongmei Zhang, Geqi Ding, Lixue Yin","doi":"10.1111/echo.70093","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>This study aims to elucidate the characteristics of segment myocardial work (MW) and reserve function through exercise stress echocardiography (ESE) and to explore the associations between MW parameters and exercise capacity in patients with left ventricular remodeling due to hypertension (LVRH).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 105 patients with LVRH (LVMI ≥ 115 g/m<sup>2</sup> for males and LVMI ≥ 95 g/m<sup>2</sup>for females) underwent ESE examination following established guidelines. Additionally, 59 healthy subjects served as a control group. Speckle tracking software was employed for analysis, calculating MW parameters by integrating longitudinal strain with the noninvasive left ventricular pressure curve. Global and segmental myocardial work indices, reserve function, and exercise capacity were evaluated and analyzed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The global work index (GWI), global constructive work (GCW), and global wasted work (GWW) were significantly elevated both at rest and peak in the LVRH group, whereas global work efficiency (GWE) was reduced. GWI shows an increasing trend from the basal to the apex, The apex segment GWI of the LVRH group exhibited the highest peak value (2754.5 ± 231.0 mmHg), while there was no significant difference in peak GWI at the basal level between the two groups. The GWI-rest and ΔGWI showed significant correlation with exercise metabolic equivalent (MET) (<i>r</i> = −0.502, <i>p</i> < 0.001) and diastolic function E/e′-peak (<i>r</i> = 0.612, <i>p</i> <0.001). Multivariable linear regression demonstrated that GWI-rest, ΔGWI provided powerful incremental value in independent associations with exercise capacity.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>MW parameters reflect the contractile force under hemodynamic overload, offering a more compelling perspective for evaluating cardiac function, including segments value. GWI-rest and ΔGWI is significantly correlated with exercise endurance in LVRH patients.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/echo.70093","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aims to elucidate the characteristics of segment myocardial work (MW) and reserve function through exercise stress echocardiography (ESE) and to explore the associations between MW parameters and exercise capacity in patients with left ventricular remodeling due to hypertension (LVRH).

Methods

A total of 105 patients with LVRH (LVMI ≥ 115 g/m² for males and LVMI ≥ 95 g/m²for females) underwent ESE examination following established guidelines. Additionally, 59 healthy subjects served as a control group. Speckle tracking software was employed for analysis, calculating MW parameters by integrating longitudinal strain with the noninvasive left ventricular pressure curve. Global and segmental myocardial work indices, reserve function, and exercise capacity were evaluated and analyzed.

Results

The global work index (GWI), global constructive work (GCW), and global wasted work (GWW) were significantly elevated both at rest and peak in the LVRH group, whereas global work efficiency (GWE) was reduced. GWI shows an increasing trend from the basal to the apex, The apex segment GWI of the LVRH group exhibited the highest peak value (2754.5 ± 231.0 mmHg), while there was no significant difference in peak GWI at the basal level between the two groups. The GWI-rest and ΔGWI showed significant correlation with exercise metabolic equivalent (MET) (r = −0.502, p < 0.001) and diastolic function E/e′-peak (r = 0.612, p <0.001). Multivariable linear regression demonstrated that GWI-rest, ΔGWI provided powerful incremental value in independent associations with exercise capacity.

Conclusion

MW parameters reflect the contractile force under hemodynamic overload, offering a more compelling perspective for evaluating cardiac function, including segments value. GWI-rest and ΔGWI is significantly correlated with exercise endurance in LVRH patients.

查看原文本刊更多论文

应激超声心动图评价高血压左心室重构患者节段性心肌功和运动耐量。

目的：本研究旨在通过运动应激超声心动图（exercise stress echocardiography， ESE）分析高血压左心室重构患者段段心肌功（segment myocardial work， MW）和储备功能的特点，探讨段段心肌功参数与运动能力的关系。方法：共有105例LVRH患者（男性LVMI≥115 g/m2，女性LVMI≥95 g/m2）按照既定指南进行了ESE检查。另外，59名健康受试者作为对照组。采用散斑跟踪软件进行分析，将纵向应变与无创左室压力曲线积分计算出MW参数。评估和分析整体和节段心肌工作指标、储备功能和运动能力。结果：LVRH组整体工作指数（GWI）、整体建设性工作（GCW）和整体浪费工作（GWW）在休息和高峰时均显著升高，而整体工作效率（GWE）降低。GWI呈从基底到尖端逐渐升高的趋势，其中LVRH组的尖端段GWI峰值最高（2754.5±231.0 mmHg），两组在基底水平的GWI峰值无显著差异。GWI-rest和ΔGWI与运动代谢当量（MET）有显著相关性（r = -0.502, p）。结论：MW参数反映了血流动力学过载下的收缩力，为评估心功能（包括节段值）提供了更有说服力的视角。GWI-rest和ΔGWI与LVRH患者运动耐力显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.