Recent Advances in Imaging of Hypertensive Heart Disease

  • Christopher L. Schumann
  • Nicholas R. Jaeger
  • Christopher M. Kramer
Hypertension and the Heart (Bharathi Upadhya, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and the Heart


Purpose of Review

To review recent advances in the imaging of hypertensive heart disease (HHD) with an emphasis on developments in the imaging of diffuse myocardial fibrosis using cardiac magnetic resonance (CMR).

Recent Findings

HHD results from long-standing hypertension and is characterized by the development of left ventricular hypertrophy and diffuse interstitial fibrosis. Diffuse fibrosis traditionally required endomyocardial biopsy to diagnose, but recent developments using T1 mapping in CMR allow for noninvasive assessment. Studies using T1 mapping have shown an increase in extracellular volume fraction (ECV) in patients with HHD compared to normal controls, suggesting ECV can be used as a noninvasive marker for fibrosis in HHD. In addition to T1 mapping, other recent advances in HHD imaging include improvements in three-dimensional echocardiography, allowing for accurate real-time volumetric measurements, and the use of speckle tracking echocardiography to detect subclinical systolic dysfunction.


Measurement of ECV using T1 mapping in CMR can be used as a noninvasive marker of diffuse myocardial fibrosis in HHD. While further studies are needed to validate this approach with larger patient cohorts, ECV can potentially be used to both monitor disease progression and assess therapeutic interventions in HHD.


Hypertensive heart disease Cardiac magnetic resonance T1 mapping Three-dimensional echocardiography Speckle tracking echocardiography 


Compliance with Ethics Guidelines

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of CardiologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Department of PathologyUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of RadiologyUniversity of VirginiaCharlottesvilleUSA

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