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Phenotyping the hypertensive heart
European Heart Journal ( IF 37.6 ) Pub Date : 2022-07-23 , DOI: 10.1093/eurheartj/ehac393
Marijana Tadic 1 , Cesare Cuspidi 2 , Thomas H Marwick 3, 4
Affiliation  

Arterial hypertension remains the most frequent cardiovascular (CV) risk factor, and is responsible for a huge global burden of disease. Echocardiography is the first-line imaging method for the evaluation of cardiac damage in hypertensive patients and novel techniques, such as 2D and D speckle tracking and myocardial work, provide insight in subclinical left ventricular (LV) impairment that would not be possible to detect with conventional echocardiography. The structural, functional, and mechanical cardiac remodelling that are detected with imaging are intermediate stages in the genesis of CV events, and initiation or intensification of antihypertensive therapy in response to these findings may prevent or delay progressive remodelling and CV events. However, LV remodelling—especially LV hypertrophy—is not specific to hypertensive heart disease (HHD) and there are circumstances when other causes of hypertrophy such as athlete heart, aortic stenosis, or different cardiomyopathies need exclusion. Tissue characterization obtained by LV strain, cardiac magnetic resonance, or computed tomography might significantly help in the distinction of different LV phenotypes, as well as being sensitive to subclinical disease. Selective use of multimodality imaging may therefore improve the detection of HHD and guide treatment to avoid disease progression. The current review summarizes the advanced imaging tests that provide morphological and functional data about the hypertensive cardiac injury.

中文翻译:

表型高血压心脏

动脉高血压仍然是最常见的心血管 (CV) 危险因素,并且是全球疾病负担的主要原因。超声心动图是评估高血压患者心脏损伤的一线成像方法,而 2D 和 D 散斑跟踪和心肌功等新技术可以深入了解无法用常规超声心动图。影像学检测到的结构、功能和机械性心脏重塑是 CV 事件发生的中间阶段,针对这些发现启动或强化抗高血压治疗可能会预防或延迟进行性重塑和 CV 事件。然而,LV 重塑——尤其是 LV 肥大——并不是高血压性心脏病 (HHD) 特有的,在某些情况下需要排除其他肥大原因,如运动员心脏、主动脉瓣狭窄或不同的心肌病。通过 LV 应变、心脏磁共振或计算机断层扫描获得的组织特征可能有助于区分不同的 LV 表型,并且对亚临床疾病敏感。因此,选择性使用多模态成像可以改善 HHD 的检测并指导治疗以避免疾病进展。目前的审查总结了提供有关高血压心脏损伤的形态和功能数据的高级成像测试。或不同的心肌病需要排除。通过 LV 应变、心脏磁共振或计算机断层扫描获得的组织特征可能有助于区分不同的 LV 表型,并且对亚临床疾病敏感。因此,选择性使用多模态成像可以改善 HHD 的检测并指导治疗以避免疾病进展。目前的审查总结了提供有关高血压心脏损伤的形态和功能数据的高级成像测试。或不同的心肌病需要排除。通过 LV 应变、心脏磁共振或计算机断层扫描获得的组织特征可能有助于区分不同的 LV 表型,并且对亚临床疾病敏感。因此,选择性使用多模态成像可以改善 HHD 的检测并指导治疗以避免疾病进展。目前的审查总结了提供有关高血压心脏损伤的形态和功能数据的高级成像测试。因此,选择性使用多模态成像可以改善 HHD 的检测并指导治疗以避免疾病进展。目前的审查总结了提供有关高血压心脏损伤的形态和功能数据的高级成像测试。因此,选择性使用多模态成像可以改善 HHD 的检测并指导治疗以避免疾病进展。目前的审查总结了提供有关高血压心脏损伤的形态和功能数据的高级成像测试。
更新日期:2022-07-23
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