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LONGITUDINAL SYSTOLIC DYSFUNCTION IN HYPERTENSIVE CARDIOMYOPATHY WITH NORMAL EJECTION FRACTION
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  • Jose Salas,
  • Oscar Sanchez,
  • Oscar Baltazar González,
  • Maria Elena Soto
Jose Salas
Centenario Hospital Miguel Hidalgo

Corresponding Author:jolsalp@gmail.com

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Oscar Sanchez
Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde
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Oscar Baltazar González
Hospital Civil de Guadalajara Unidad Hospitalaria Juan I Menchaca
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Maria Elena Soto
INC IGNACIO CHAVEZ
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Abstract

Background: The left ventricle (LV) journey in their transition from hypertrophy to heart failure is marked by many subcellular events partially understood yet. The moment in which the structural abnormalities reach the umbral to induce myocardial dysfunction remains elusive. Aims: To evaluate the anatomic-functional relationship between LV wall thickness and longitudinal systolic dysfunction. Material and Methods: We prospectively performed clinical history and transthoracic echocardiogram on healthy individuals and patients with hypertension, left ventricle ejection fraction (LVEF) ≥50%, and absence of heart failure symptoms. Results: A total of 226 patients and 101 healthy individuals were recruited. The distribution for sex was similar between groups. The mean age was 67±13 years old in the patients, and 44% had concentric LV hypertrophy. LVEF was identical in both groups (63±6%); in contrast, global longitudinal strain (GLS) (-18.8±2.5% vs. -20.4±2%) and mitral annulus plane systolic excursion (MAPSE) (13.8±2.8 vs. 15.5±2mm) were lower. ROC curve classified optimally decreased GLS with LV septum thickness ≥13mm and decreased MAPSE with thickness ≥14mm. Multivariable logistic regression found that LV septum thickness is the only variable associated with longitudinal systolic dysfunction (OR= 1.1, CI95%= 1.05 – 1.15, p= 0.001, R squared= 0.38). Discussion: A progressive increase in LV wall thickness due to myocyte hypertrophy and interstitial expansion is associated with LV systolic longitudinal dysfunction. Conclusions: Patients with moderate or severe ventricular hypertrophy (septum ≥13mm) had longitudinal systolic dysfunction, GLS decreases with minor structural change than MAPSE, and LVEF is insensitive in detecting longitudinal myocardial dysfunction in patients with hypertension.
19 Aug 2021Submitted to Echocardiography
19 Aug 2021Submission Checks Completed
19 Aug 2021Assigned to Editor
22 Aug 2021Reviewer(s) Assigned
13 Sep 2021Review(s) Completed, Editorial Evaluation Pending
13 Sep 2021Editorial Decision: Revise Major
17 Sep 20211st Revision Received
17 Sep 2021Submission Checks Completed
17 Sep 2021Assigned to Editor
18 Sep 2021Reviewer(s) Assigned
04 Oct 2021Review(s) Completed, Editorial Evaluation Pending
09 Oct 2021Editorial Decision: Revise Minor
11 Oct 20212nd Revision Received
12 Oct 2021Submission Checks Completed
12 Oct 2021Assigned to Editor
12 Oct 2021Reviewer(s) Assigned
22 Oct 2021Review(s) Completed, Editorial Evaluation Pending
09 Nov 2021Editorial Decision: Accept