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Hemodynamic Markers in the Progression from Hypertension to Heart Failure

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Hypertension and Heart Failure

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

It is of importance to better understand the pathophysiological mechanisms leading to left ventricular (LV) maladaptation and the timely identification and management of patients at risk of developing symptomatic heart failure (HF). High blood pressure is the major modifiable risk factor for overt HF. In patients with hypertension, the process of myocardial remodeling/dysfunction starts long before the onset of HF symptoms. The long-term increased afterload (high pressure) and, consequently, the chronically increased cardiac performance lead to LV concentric remodeling, decreased longitudinal systolic deformation (strain), diastolic dysfunction, and increased LV oxygen requirements. All these processes eventually result in symptomatic HF. Recent studies have revealed a high prevalence of asymptomatic (or subclinical) LV remodeling and systolic and diastolic dysfunction in the community. In this chapter, we discuss the various aspects of cardiac maladaptation to a chronically increased hemodynamic load. We also illustrate the complex interaction between the different components of blood pressure, arterial properties, and echocardiographic indexes reflecting LV function and structure.

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References

  1. De Tombe PP, Jones S, Burkhoff D, Hunter WC, Kass DA. Ventricular stroke work and efficiency both remain nearly optimal despite altered vascular loading. Am J Physiol. 1993;264(6 Pt 2):H1817–24.

    Google Scholar 

  2. Moriarty TF. The law of Laplace. Its limitations as a relation for diastolic pressure, volume, or wall stress of the left ventricle. Circ Res. 1980;46(3):321–31.

    Article  CAS  Google Scholar 

  3. Devereux RB, Roman MJ. Left ventricular hypertrophy in hypertension: stimuli, patterns, and consequences. Hypertens Res. 1999;22(1):1–9.

    Article  CAS  Google Scholar 

  4. Zile MR, Gaasch WH, Patel K, Aban IB, Ahmed A. Adverse left ventricular remodeling in community-dwelling older adults predicts incident heart failure and mortality. JACC Heart Fail. 2014;2(5):512–22.

    Article  Google Scholar 

  5. Velagaleti RS, Gona P, Pencina MJ, Aragam J, Wang TJ, Levy D, et al. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014;113(1):117–22.

    Article  Google Scholar 

  6. Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J. 2001;141(3):334–41.

    Article  CAS  Google Scholar 

  7. Kuznetsova T, Thijs L, Knez J, Cauwenberghs N, Petit T, Gu YM, et al. Longitudinal changes in left ventricular diastolic function in a general population. Circ Cardiovasc Imaging. 2015;8(4):e002882.

    Article  Google Scholar 

  8. Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation. 2000;102(15):1788–94.

    Article  CAS  Google Scholar 

  9. Kuznetsova T, Cauwenberghs N, Sabovčik F, Kobayashi Y, Haddad F. Evaluation of diastole by echocardiography for detecting early cardiac dysfunction: an outcome study. ESC Heart Fail. 2022;9:1775.

    Article  Google Scholar 

  10. Shim CY, Park S, Choi D, Yang WI, Cho IJ, Choi EY, et al. Sex differences in central hemodynamics and their relationship to left ventricular diastolic function. J Am Coll Cardiol. 2011;57(10):1226–33.

    Article  Google Scholar 

  11. Coutinho T, Borlaug BA, Pellikka PA, Turner ST, Kullo IJ. Sex differences in arterial stiffness and ventricular-arterial interactions. J Am Coll Cardiol. 2013;61(1):96–103.

    Article  Google Scholar 

  12. Cauwenberghs N, Knez J, D’hooge J, Thijs L, Yang W-Y, Wei F-F, et al. Longitudinal changes in LV structure and diastolic function in relation to arterial properties in general population. JACC Cardiovasc Imaging. 2017;10(11):1307–16.

    Article  Google Scholar 

  13. Borlaug BA. Sex, load, and relaxation: are women more susceptible to load-dependent diastolic dysfunction? J Am Coll Cardiol. 2011;57(10):1234–6.

    Article  Google Scholar 

  14. Cauwenberghs N, Knez J, Tikhonoff V, D’hooge J, Kloch-Badelek M, Thijs L, et al. Doppler indexes of left ventricular systolic and diastolic function in relation to the arterial stiffness in a general population. J Hypertens. 2016;34(4):762–71.

    Article  CAS  Google Scholar 

  15. Hayward CS, Kalnins WV, Kelly RP. Gender-related differences in left ventricular chamber function. Cardiovasc Res. 2001;49(2):340–50.

    Article  CAS  Google Scholar 

  16. Choi HF, D’hooge J, Rademakers FE, Claus P. Distribution of active fiber stress at the beginning of ejection depends on left-ventricular shape. Conf Proc Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf. 2010;2010:2638–41.

    Google Scholar 

  17. Spotnitz HM. Macro design, structure, and mechanics of the left ventricle. J Thorac Cardiovasc Surg. 2000;119(5):1053–77.

    Article  CAS  Google Scholar 

  18. Gould KL, Kennedy JW, Frimer M, Pollack GH, Dodge HT. Analysis of wall dynamics and directional components of left ventricular contraction in man. Am J Cardiol. 1976;38(3):322–31.

    Article  CAS  Google Scholar 

  19. Sengupta PP. Left ventricular transmural mechanics: tracking opportunities in-depth. J Am Soc Echocardiogr. 2009;22(9):1022–4.

    Article  Google Scholar 

  20. Cheng S, Larson MG, McCabe EL, Osypiuk E, Lehman BT, Stanchev P, et al. Age- and sex-based reference limits and clinical correlates of myocardial strain and synchrony. Circ Cardiovasc Imaging. 2013;6(5):692–9.

    Article  Google Scholar 

  21. Lumens J, Prinzen FW, Delhaas T. Longitudinal strain: “think globally, track locally”. JACC Cardiovasc Imaging. 2015;8(12):1360–3.

    Article  Google Scholar 

  22. Sengupta PP, Narula J. Reclassifying heart failure: predominantly subendocardial, subepicardial, and transmural. Heart Fail Clin. 2008;4(3):379–82.

    Article  Google Scholar 

  23. Donal E, Bergerot C, Thibault H, Ernande L, Loufoua J, Augeul L, et al. Influence of afterload on left ventricular radial and longitudinal systolic functions: a two-dimensional strain imaging study. Eur J Echocardiogr. 2009;10(8):914–21.

    Article  Google Scholar 

  24. Tadic M, Sala C, Carugo S, Mancia G, Grassi G, Cuspidi C. Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies. J Hypertens. 2021;39(10):2103–12.

    Article  CAS  Google Scholar 

  25. Ballo P, Quatrini I, Giacomin E, Motto A, Mondillo S. Circumferential versus longitudinal systolic function in patients with hypertension: a nonlinear relation. J Am Soc Echocardiogr. 2007;20(3):298–306.

    Article  Google Scholar 

  26. Baltabaeva A, Marciniak M, Bijnens B, Moggridge J, He FJ, Antonios TF, et al. Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension. Eur J Echocardiogr. 2008;9(4):501–8.

    Google Scholar 

  27. Soufi Taleb Bendiab N, Meziane-Tani A, Ouabdesselam S, Methia N, Latreche S, Henaoui L, et al. Factors associated with global longitudinal strain decline in hypertensive patients with normal left ventricular ejection fraction. Eur J Prev Cardiol. 2017;24(14):1463–72.

    Article  Google Scholar 

  28. Kuznetsova T, Nijs E, Cauwenberghs N, Knez J, Thijs L, Haddad F, et al. Temporal changes in left ventricular longitudinal strain in general population: clinical correlates and impact on cardiac remodeling. Echocardiography. 2019;36(3):458–68.

    Article  Google Scholar 

  29. Kawaguchi M, Hay I, Fetics B, Kass DA. Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation. 2003;107(5):714–20.

    Article  Google Scholar 

  30. Davies JE, Baksi J, Francis DP, Hadjiloizou N, Whinnett ZI, Manisty CH, et al. The arterial reservoir pressure increases with aging and is the major determinant of the aortic augmentation index. Am J Physiol Heart Circ Physiol. 2010;298(2):H580–6.

    Article  CAS  Google Scholar 

  31. Wang JJ, O’Brien AB, Shrive NG, Parker KH, Tyberg JV. Time-domain representation of ventricular-arterial coupling as a windkessel and wave system. Am J Physiol Heart Circ Physiol. 2003;284(4):H1358–68.

    Article  CAS  Google Scholar 

  32. Schultz MG, Davies JE, Hardikar A, Pitt S, Moraldo M, Dhutia N, et al. Aortic reservoir pressure corresponds to cyclic changes in aortic volume: physiological validation in humans. Arterioscler Thromb Vasc Biol. 2014;34(7):1597–603.

    Article  CAS  Google Scholar 

  33. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness. A systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27.

    Article  Google Scholar 

  34. Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014;63(7):636–46.

    Article  Google Scholar 

  35. Tsao CW, Lyass A, Larson MG, Levy D, Hamburg NM, Vita JA, et al. Relation of central arterial stiffness to incident heart failure in the community. J Am Heart Assoc. 2015;4(11):e002189.

    Article  Google Scholar 

  36. Vasan RS, Pan S, Xanthakis V, Beiser A, Larson MG, Seshadri S, et al. Arterial stiffness and long-term risk of health outcomes: the Framingham heart study. Hypertension. 2022;79(5):1045–56.

    Article  CAS  Google Scholar 

  37. Kuznetsova T, Cauwenberghs N, Knez J, Yang W-Y, Herbots L, D’hooge J, et al. Additive prognostic value of left ventricular systolic dysfunction in a population-based cohort. Circ Cardiovasc Imaging. 2016;9(7):e004661.

    Article  Google Scholar 

  38. Sunagawa K, Sagawa K, Maughan WL. Ventricular interaction with the vascular system in terms of pressure-volume relationships. In: Ventriculo-vascular coupling: clinical, physiologic, and engineering aspects. New York: Springer Verlag; 1987. p. 210–39.

    Chapter  Google Scholar 

  39. Saba PS, Ganau A, Devereux RB, Pini R, Pickering TG, Roman MJ. Impact of arterial elastance as a measure of vascular load on left ventricular geometry in hypertension. J Hypertens. 1999;17(7):1007–15.

    Article  CAS  Google Scholar 

  40. Chantler PD, Melenovsky V, Schulman SP, Gerstenblith G, Becker LC, Ferrucci L, et al. The sex-specific impact of systolic hypertension and systolic blood pressure on arterial-ventricular coupling at rest and during exercise. Am J Physiol Heart Circ Physiol. 2008;295(1):H145–53.

    Article  CAS  Google Scholar 

  41. Kuznetsova T, D’hooge J, Kloch-Badelek M, Sakiewicz W, Thijs L, Staessen JA. Impact of hypertension on ventricular-arterial coupling and regional myocardial work at rest and during isometric exercise. J Am Soc Echocardiogr. 2012;25(8):882–90.

    Article  Google Scholar 

  42. Cohen-Solal A, Caviezel B, Himbert D, Gourgon R. Left ventricular-arterial coupling in systemic hypertension: analysis by means of arterial effective and left ventricular elastances. J Hypertens. 1994;12(5):591–600.

    Article  CAS  Google Scholar 

  43. Cauwenberghs N, Tabassian M, Thijs L, Yang W-Y, Wei F-F, Claus P, et al. Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study. Cardiovasc Ultrasound. 2019;17(1):15.

    Article  Google Scholar 

  44. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010;23(4):351–5.

    Article  Google Scholar 

  45. Urheim S, Rabben SI, Skulstad H, Lyseggen E, Ihlen H, Smiseth OA. Regional myocardial work by strain Doppler echocardiography and LV pressure: a new method for quantifying myocardial function. Am J Physiol Heart Circ Physiol. 2005;288(5):H2375–80.

    Article  CAS  Google Scholar 

  46. Russell K, Eriksen M, Aaberge L, Wilhelmsen N, Skulstad H, Remme EW, et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work. Eur Heart J. 2012;33(6):724–33.

    Article  Google Scholar 

  47. Truong VT, Vo HQ, Ngo TNM, Mazur J, Nguyen TTH, Pham TTM, et al. Normal ranges of global left ventricular myocardial work indices in adults: a meta-analysis. J Am Soc Echocardiogr. 2022;35(4):369–377.e8.

    Article  Google Scholar 

  48. Sahiti F, Morbach C, Cejka V, Tiffe T, Wagner M, Eichner FA, et al. Impact of cardiovascular risk factors on myocardial work—insights from the STAAB cohort study. J Hum Hypertens. 2022;36(3):235–45.

    Article  Google Scholar 

  49. Sahiti F, Morbach C, Cejka V, Albert J, Eichner FA, Gelbrich G, et al. Left ventricular remodeling and myocardial work: results from the population-based STAAB cohort study. Front Cardiovasc Med. 2021;8:669335.

    Article  CAS  Google Scholar 

  50. Tadic M, Cuspidi C, Pencic B, Vukomanovic V, Taddei S, Grassi G, et al. Association between myocardial work and functional capacity in patients with arterial hypertension: an echocardiographic study. Blood Press. 2021;30(3):188–95. https://doi.org/10.1080/08037051.2021.1902267.

    Article  CAS  Google Scholar 

  51. Hubert A, Le Rolle V, Leclercq C, Galli E, Samset E, Casset C, et al. Estimation of myocardial work from pressure-strain loops analysis: an experimental evaluation. Eur Heart J Cardiovasc Imaging. 2018;19(12):1372–9.

    Article  Google Scholar 

  52. Papadopoulos K, Özden Tok Ö, Mitrousi K, Ikonomidis I. Myocardial work: methodology and clinical applications. Diagnostics. 2021;11(3):573.

    Article  Google Scholar 

  53. Shah AM, Solomon SD. Phenotypic and pathophysiological heterogeneity in heart failure with preserved ejection fraction. Eur Heart J. 2012;33(14):1716–7.

    Article  Google Scholar 

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Authors and Affiliations

  1. Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium

    Nicholas Cauwenberghs & Tatiana Kuznetsova

Authors
  1. Nicholas Cauwenberghs
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  2. Tatiana Kuznetsova
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Correspondence to Tatiana Kuznetsova .

Editor information

Editors and Affiliations

  1. Carol Davila University of Medicine and Pharmacy, Bucharest, Bucuresti, Romania

    Maria Dorobantu

  2. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

  3. University of Milano-Bicocca, Milano, Italy

    Guido Grassi

  4. Dept of Clinical and Experimental Sci, University of Brescia, Brescia, Italy

    Enrico Agabiti-Rosei

  5. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Cauwenberghs, N., Kuznetsova, T. (2023). Hemodynamic Markers in the Progression from Hypertension to Heart Failure. In: Dorobantu, M., Voicu, V., Grassi, G., Agabiti-Rosei, E., Mancia, G. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-39315-0_7

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  • DOI: https://doi.org/10.1007/978-3-031-39315-0_7

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