Additional Impact of Aortic Regurgitation on Left Ventricular Strain and Remodeling in Essential Hypertension Patients Evaluated Using MRI

• Published in: Journal of magnetic resonance imaging Vol. 60; no. 1; pp. 339 - 349
• Main Authors: Yan, Wei‐Feng, Yang, Zhi‐Gang, Li, Xue‐Ming, Tang, Si‐Shi, Guo, Ying‐Kun, Jiang, Li, Min, Chen‐Yan, Li, Yuan
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2024; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aorta; aortic regurgitation; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - physiopathology; Correlation coefficient; Correlation coefficients; Echocardiography; Essential Hypertension - complications; Essential Hypertension - diagnostic imaging; Essential Hypertension - physiopathology; Female; Field strength; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - physiopathology; Hypertrophy; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - physiopathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging, Cine; Male; Middle Aged; myocardial strain; Phenotypes; Population studies; Regression analysis; Regurgitation; Retrospective Studies; Statistical analysis; Statistical tests; Variance analysis; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Ventricular Remodeling; myocardial strain; hypertension; aortic regurgitation
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.29117

Background Understanding the impact of aortic regurgitation (AR) on hypertensive patients' hearts is important. Purpose To assess left ventricular (LV) strain and structure in hypertensive patients and investigate the relationship with AR severity. Study Type Retrospective. Population 263 hypertensive patients (99 with AR) and 62 controls, with cardiac MRI data. Field Strength/Sequence Balanced steady‐state free precession (bSSFP) sequence at 3.0T. Assessment AR was classified as mild, moderate, or severe based on echocardiographic findings. LV geometry was classified as normal, concentric remodeling, eccentric hypertrophy, or concentric hypertrophy based on MRI assessment of LV mass/volume ratio and LV Mass index (LVMI). LV global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS) were obtained by post‐processing bSSFP cine datasets using commercial software. Statistical Tests ANOVA, Kruskal–Wallis test, Spearman's correlation coefficients (r), chi‐square test, and multivariable linear regression analysis. A P value <0.05 was considered statistically significant. Results Hypertensive patients with AR had significantly lower LV myocardial strain and higher LVMI than the group without AR (GRPS 26.25 ± 12.23 vs. 34.53 ± 9.85, GCPS −17.4 ± 5.84 vs. −20.57 ± 3.57, GLPS −9.86 ± 4.08 vs. −12.95 ± 2.94, LVMI 90.56 ± 38.56 vs.58.84 ± 17.55). Of the 99 patients with AR, 56 had mild AR, 26 had moderate AR and 17 had severe AR. The degree of AR was significantly negatively correlated to the absolute values of LV GRPS, GCPS and GLPS (r = −0.284 – −0.416). LV eccentric hypertrophy increased significantly with AR severity (no AR 21.3%, mild AR 42.9%, moderate AR 73.1%, severe AR 82.4%). In multivariable analysis, the degree of AR was an independent factor affecting LV global strain and LVMI even after considering confounding factors (β values for global myocardial strain were −0.431 to −0.484, for LVMI was 0.646). Data Conclusion Increasing AR severity leads to decreased cardiac function and worse ventricular geometric phenotypes in hypertensive patients. Level of Evidence 4 Technical Efficacy Stage 3