Experimental Study on Evaluation of Left Atrial and Ventricular Function in Hypertensive Heart Disease by Cardiac Magnetic Resonance
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i1.5064
Abstract
Objective: To investigate the value of cardiac magnetic resonance feature tracking (CMR-FT) in assessing left heart function in hypertensive heart disease (HHD) patients and to preliminarily explore the relationship between left atrial (LA) and left ventricular (LV) function1. Methods: Ten Bama minipigs were randomly divided into an experimental group (N=6) and a control group (N=4). The experimental group underwent laparotomy with left renal artery ligation to establish a hypertension model, whereas the control group underwent laparotomy without ligation. CMR-FTs were performed at baseline and at 16 weeks post-surgery. Global LA and LV functional parameters were measured via CVI42 postprocessing software. Results: Left atrial volumetric indices LAVImin and LAVImax were significantly greater in the hypertension group at 16 weeks (LAVImin 17.65±1.66 vs 11.13±1.60 mL/m², P<0.001; LAVImax 27.05±2.19 vs 20.75±3.13 mL/m², P=0.005). LA reservoir and conduit function deteriorated early: εs and εe were decreased at 16 weeks (εs 27.22±3.71 vs 39.53±2.72, P<0.001; εe 12.10±2.02 vs 23.00±1.77, P<0.001). LV volumetric parameters and LVEF remained comparable between groups at all time points (all P>0.05), whereas LV strain indices were significantly impaired in the hypertension group at 16 weeks (e.g., LVRS 29.55±1.80 vs 43.18±1.35; LVCS −16.58±0.87 vs −19.63±0.99; LVLS −12.63±1.73 vs −18.33±0.76; all P≤0.039). Moreover, the LVLS was positively correlated with εs (r=0.814) and εe (r=0.875) and negatively correlated with LA volume (LAVmin r=−0.817; LAVmax r=−0.907), whereas the LVRS was also associated with LA function (all P<0.05). Conclusion: CMR-FT can detect structural and functional impairments of the LA and LV in early-stage HHD earlier, more sensitively, and more accurately than conventional cardiac functional parameters. Furthermore, significant correlations exist between LA and LV functional parameters.
Keywords
hypertensive heart disease; cardiac magnetic resonance; myocardial strain; left ventricular function; left atrial function
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[15]Li L, Chen X, Yin G, et al. Early detection of left atrial dysfunction assessed by CMR feature tracking in hypertensive patients. Eur Radiol. 2020;30(2):702-711.
[16]Thomas L, Marwick TH, Popescu BA, Donal E, Badano LP. Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019;73(15):1961-1977.
[17]Zhang M, Li Y, Wu X, et al. Clinical Study on Left Atrial Phasic Function and Mechanical Dispersion in Hypertensive Patients with Left Ventricular Diastolic Dysfunction (in Chinese). Chin J Ultrasound Med. 2020;36(5):417-420.
[2]Nemtsova V, Vischer AS, Burkard T. Hypertensive Heart Disease: A Narrative Review Series-Part 1: Pathophysiology and Microstructural Changes. J Clin Med. 2023 Mar 30;12(7):2606.
[3]Triposkiadis F, Pieske B, Butler J, et al. Global left atrial failure in heart failure. Eur J Heart Fail. 2016;18(11):1307-1320.
[4]Adamo M, Gardner RS, McDonagh TA, Metra M. The 'Ten Commandments' of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2022;43(6):440-441.
[5]Li L, Chen X, Yin G, et al. Early detection of left atrial dysfunction assessed by CMR feature tracking in hypertensive patients. Eur Radiol. 2020;30(2):702-711.
[6]Song R, Liu Z, Huang J, et al. Evaluation of Left Ventricular Systolic Function in Patients with Essential Hypertension and Preserved Ejection Fraction Using Layer-Specific Strain (in Chinese). Chin J Clin Med Imaging. 2020;31(9):641-646.
[7]Jama HA, Muralitharan RR, Xu C, O'Donnell JA, Bertagnolli M, Broughton BRS, Head GA, Marques FZ. Rodent models of hypertension. Br J Pharmacol. 2022 Mar;179(5):918-937.
[8]Jia H, Chang Y, Song J. The pig as an optimal animal model for cardiovascular research. Lab Anim (NY). 2024;53(6):136-147.
[9]Tadic M, Cuspidi C, Marwick TH. Phenotyping the hypertensive heart. Eur Heart J. 2022;43(38):3794-3810.
[10]Rahman ZU, Sethi P, Murtaza G, Virk HUH, Rai A, Mahmod M et al. Feature tracking cardiac magnetic resonance imaging: a review of a novel noninvasive cardiac imaging technique. World J Cardiol. 2017;9:312–319.
[11]Ayoub AM, Keddeas VW, Ali YA, El Okl RA. Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction. Clin Med Insights Cardiol. 2016;10:85-90. Published 2016 Jun 27.
[12]Li R, Lei F, Liu F, et al. The transition from hypertension to hypertensive heart disease and heart failure with preserved ejection fraction: a retrospective cross-sectional study of myocardial magnetic resonance strain and tissue characteristics. Quant Imaging Med Surg. 2024;14(10):7684-7696.
[13]Fung MJ, Thomas L, Leung DY. Left atrial function: Correlation with left ventricular function and contractile reserve in patients with hypertension. Echocardiography. 2018;35(10):1596-1605.
[14]Chen X, Li L, Song Y, et al. Quantitative Study on Early Left Atrial Dysfunction in Hypertensive Patients Based on Cardiac Magnetic Resonance Feature Tracking (in Chinese). Chin J Magn Reson Imaging. 2020;11(4):281-285.
[15]Li L, Chen X, Yin G, et al. Early detection of left atrial dysfunction assessed by CMR feature tracking in hypertensive patients. Eur Radiol. 2020;30(2):702-711.
[16]Thomas L, Marwick TH, Popescu BA, Donal E, Badano LP. Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019;73(15):1961-1977.
[17]Zhang M, Li Y, Wu X, et al. Clinical Study on Left Atrial Phasic Function and Mechanical Dispersion in Hypertensive Patients with Left Ventricular Diastolic Dysfunction (in Chinese). Chin J Ultrasound Med. 2020;36(5):417-420.
Copyright © 2026 Mingliang Wu, Xin He, Shibo Wang, Bo Li, Yanfeng Hu, Xin Zhang, Ning Su
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