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Echocardiography (Mount Kisco, N.Y.)
Mar, 2025;42 (3): e70093.

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

Qingfeng Zhang, Yi Wang, Hongmei Zhang, Geqi Ding, Lixue Yin
Author Information
  1. Qingfeng Zhang: School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. ORCID
  2. Yi Wang: Department of Key Laboratory in Cardiac Electrophysiology and Biomechanics and Cardiovascular Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, China. ORCID
  3. Hongmei Zhang: Department of Key Laboratory in Cardiac Electrophysiology and Biomechanics and Cardiovascular Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, China.
  4. Geqi Ding: Department of Key Laboratory in Cardiac Electrophysiology and Biomechanics and Cardiovascular Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, China.
  5. Lixue Yin: School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
PMID: 40116150 DOI: 10.1111/echo.70093

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/m for males and LVMI ��� 95 g/mfor 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 ��GWI 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, ��GWI 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 ��GWI is significantly correlated with exercise endurance in LVRH patients.

Keywords

exercise stress hypertension myocardial work pressure���strain loop

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Grants

  1. 2023NSFSC0641/Sichuan Provincial Natural Science Foundation
  2. 2022NSFS0605/Sichuan science and technology project

MeSH Term

Humans
Male
Female
Ventricular Remodeling
Middle Aged
Echocardiography, Stress
Exercise Tolerance
Hypertension
Heart Ventricles
Ventricular Function, Left
Journal Article

Word Cloud

Created with Highcharts 10.0.0workexerciseLVRHMWfunctionglobalGWImyocardialparameterscapacitypatientsgrouppeakvalueGWI-rest��GWIsegmentreservestressESEassociationsleftventricularhypertensionLVMIsignificantlybasalapexsignificantr=001PURPOSE:studyaimselucidatecharacteristicsechocardiographyexploreremodelingdueMETHODS:total105��� 115 g/mmales��� 95 g/mforfemalesunderwentexaminationfollowingestablishedguidelinesAdditionally59healthysubjectsservedcontrolSpeckletrackingsoftwareemployedanalysiscalculatingintegratinglongitudinalstrainnoninvasivepressurecurveGlobalsegmentalindicesevaluatedanalyzedRESULTS:indexconstructiveGCWwastedGWWelevatedrestwhereasefficiencyGWEreducedshowsincreasingtrendexhibitedhighest27545��2310 mmHgdifferenceleveltwogroupsshowedcorrelationmetabolicequivalentMET-0502p < 0diastolicE/e'-peak0612p<0MultivariablelinearregressiondemonstratedprovidedpowerfulincrementalindependentCONCLUSION:reflectcontractileforcehemodynamicoverloadofferingcompellingperspectiveevaluatingcardiacincludingsegmentscorrelatedenduranceEvaluationSegmentalMyocardialWorkExerciseToleranceHypertensionPatientsLeftVentricularRemodelingStressEchocardiographypressure���strainloop

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