Association between myocardial work and functional capacity in patients with arterial hypertension: an echocardiographic study

Abstract

Purpose

The aim of this study was to examine myocardial performance using pressure-strain loops in hypertensive patients with different level of blood pressure control.

Material and methods

This cross-sectional study included 204 subjects (45 controls, 70 patients with well-controlled hypertension, 58 patients with uncontrolled hypertension and 31 patients with resistant hypertension) who underwent complete two-dimensional echocardiographic examination including two-dimensional speckle-tracking echocardiography. Pressure-strain curve was used to determine global myocardial work, constructive work, wasted work and work efficiency in all study participants.

Results

Left ventricular (LV) longitudinal strain gradually reduced from controls throughout well-controlled hypertensive patients, to patients with uncontrolled and resistant hypertension. Global myocardial work was higher in patients with uncontrolled and resistant hypertension than in controls and well-controlled hypertension. Constructive work was also higher in all hypertensive patients than in controls. Global wasted work and work efficiency were similar between different groups. Global myocardial work index was associated with peak oxygen consumption independently of sex, age, body mass index (BMI), LV structural and functional parameters in all hypertensive participants.

Conclusions

Myocardial work was significantly deteriorated in patients with uncontrolled and resistant arterial hypertension compared to controls and well-controlled hypertensive patients. Global myocardial work was associated with functional capacity independent of clinical and echocardiographic parameters.

Keywords:

• Hypertension
• left ventricle
• myocardial work

Author contributions

MT and VC contributed to the study design, collecting data, analysis and writing the article, CC contributed to study design, interpretation of data and writing the article, BP and VV contributed to the data collection and methodology, ST and GG contributed to the interpretation of data and revised it with important intellectual contribution.

Disclosure statement

The authors declare no conflict of interest related to this study.