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Integrating Measures of Myocardial Fibrosis in the Transition from Hypertensive Heart Disease to Heart Failure

  • Hypertension and the Heart (B Upadhya, Section Editor)
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Abstract

Purpose of Review

This review aims to summarize recent developments in identifying and quantifying both the presence and amount of myocardial fibrosis by imaging and biomarkers. Further, this review seeks to describe in general ways how this information may be used to identify hypertension and the transition to heart failure with preserved ejection fraction.

Recent Findings

Recent studies using cardiac magnetic resonance imaging highlight the progressive nature of fibrosis from normal individuals to those with hypertension to those with clinical heart failure. However, separating hypertensive patients from those with heart failure remains challenging. Recent studies involving echocardiography show the subclinical myocardial strain changes between hypertensive heart disease and heart failure. Lastly, recent studies highlight the potential use of biomarkers to identify those with hypertension at the greatest risk of developing heart failure.

Summary

In light of the heterogeneous nature between hypertension and heart failure with preserved ejection fraction, an integrated approach with cardiac imaging and biomarker analysis may enable clinicians and investigators to more accurately characterize, prevent, and treat heart failure in those with hypertension.

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  1. Division of Cardiovascular Medicine, Wake Forest University School of Medicine, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA

    R. Brandon Stacey & W. Gregory Hundley

  2. Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    W. Gregory Hundley

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Stacey, R.B., Hundley, W.G. Integrating Measures of Myocardial Fibrosis in the Transition from Hypertensive Heart Disease to Heart Failure. Curr Hypertens Rep 23, 22 (2021). https://doi.org/10.1007/s11906-021-01135-8

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