Hypertensive Heart Disease Patients Research Articles

Discrimination models with radiomics features derived from cardiovascular magnetic resonance images for distinguishing hypertensive heart disease from hypertrophic cardiomyopathy.

Discriminating hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) is challenging, because both are characterized by left ventricular hypertrophy (LVH). Radiomics might be effective to differentiate HHD from HCM. Therefore, this study aimed to investigate discriminators and build discrimination models between HHD and HCM using multiparametric cardiac magnetic resonance (CMR) findings and radiomics score (radscore) derived from late gadolinium enhancement (LGE) and cine images. In this single center, retrospective study, 421 HCM patients [median and interquartile range (IQR), 50.0 (38.0-59.0) years; male, 70.5%] from January 2017 to September 2021 and 200 HHD patients [median and IQR, 44.5 (35.0-57.0) years; male, 88.5%] from September 2015 to July 2022 were consecutively included and randomly stratified into a training group and a validation group at a ratio of 6:4. Multiparametric CMR findings were obtained using cvi42 software and radiomics features using Python software. After dimensional reduction, the radscore was calculated by summing the remaining radiomics features weighted by their coefficients. Multiparametric CMR findings and radscore that were statistically significant in univariate logistic regression were used to build combined discrimination models via multivariate logistic regression. After multivariate logistic regression, the maximal left ventricular end diastolic wall thickness (LVEDWT), left ventricular ejection fraction (LVEF), presence of LGE, cine radscore and LGE radscore were identified as significant characteristics and used to build a combined discrimination model. This model achieved an area under the receiver operator characteristic curve (AUC) of 0.979 (0.968-0.990) in the training group and 0.981 (0.967-0.995) in the validation group, significantly better than the model using multiparametric CMR findings alone (P<0.001). Radiomics features derived from cardiac cine and LGE images can effectively discriminate HHD from HCM.

Hypertensive Heart Disease: A Narrative Review Series-Part 3: Vasculature, Biomarkers and the Matrix of Hypertensive Heart Disease.

Over the last few decades, research efforts have resulted in major advances in our understanding of the pathophysiology of hypertensive heart disease (HHD). This is the third part of a three-part review series. Here, we focus on the influence of high blood pressure on the micro- and macroalterations that occur in the vasculature in HHD. We also provide an overview of circulating cardiac biomarkers that may prove useful for a better understanding of the pathophysiology, development and progression of HHD, and may play a unique role in the diagnostic and prognostic evaluation of patients with HHD, taking into account their properties showing as abnormal long before the onset of the disease. In the conclusion, we propose an updated definition of HHD and a matrix for clinical classification, which we suspect will be useful in practice, allowing an individual approach to HHD patients.

Obstructive Sleep Apnea and Hypertensive Heart Disease: From Pathophysiology to Therapeutics.

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of complete or partial obstruction of the upper airway that lead to intermittent hypoxemia, negative intrathoracic pressure, hypercapnia, and sleep disturbances. While OSA is recognized as a significant risk factor for cardiovascular disease, it's relationship with hypertensive heart disease (HHD) remains underappreciated. HHD is a condition characterized by the pathological hypertrophy of the left ventricle, a consequence of elevated arterial hypertension. Interestingly, both OSA and HHD share similar underlying mechanisms including hypertension, left ventricular hypertrophy, myocardial fibrosis, oxidative stress, and inflammation, which ultimately contribute to the progression of HHD. This review aims to shed light on the potential role of OSA in HHD pathogenesis, summarizing current OSA treatment options. It is hoped that this review will encourage a renewed clinical focus on HHD and underscore the need for further OSA research, particularly in the context of screening and treating HHD patients.

Spiritual Emotional Freedom Technique Intervention on Anxiety Level of Hypertensive Heart Disease Patients

Hypertension is one of the leading causes of various heart diseases. In patients with Hypertensive Heart Disease (HHD), anxiety symptoms can continue to increase, which can affect the treatment and healing process and can cause various complications. This study aims to determine the effect of Spiritual Emotional Freedom Technique (SEFT) therapy on anxiety levels in HHD patients in the ICCU room of Kendari City Hospital. This type of research is a pre-experiment with a one-group pretest-posttest design. The population in this study were all HHD patients treated in the ICCU room of Kendari City Hospital. The sampling technique used was purposive sampling, with a total sample size of 22 respondents. This research instrument uses the Anxiety Visual Analog Scale (VAS-A) questionnaire sheet to measure anxiety levels. The analysis method uses a paired-sample t-test. The results showed that the level of anxiety before and after SEFT therapy decreased. This can be seen from the statistical test p-value = 0.000 &lt; α = 0.05, which shows a significant difference. It can be concluded that SEFT therapy influences reducing anxiety levels in HHD patients. It is expected for service institutions and other institutions to provide training for health workers to perform SEFT therapy to help reduce patient anxiety levels.

Deep Learning for Discrimination of Hypertrophic Cardiomyopathy and Hypertensive Heart Disease on MRI Native T1 Maps.

Native T1 and radiomics were used for hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) differentiation previously. The current problem is that global native T1 remains modest discrimination performance and radiomics requires feature extraction beforehand. Deep learning (DL) is a promising technique in differential diagnosis. However, its feasibility for discriminating HCM and HHD has not been investigated. To examine the feasibility of DL in differentiating HCM and HHD based on T1 images and compare its diagnostic performance with other methods. Retrospective. 128 HCM patients (men, 75; age, 50 years ± 16) and 59 HHD patients (men, 40; age, 45 years ± 17). 3.0T; Balanced steady-state free precession, phase-sensitive inversion recovery (PSIR) and multislice native T1 mapping. Compare HCM and HHD patients baseline data. Myocardial T1 values were extracted from native T1 images. Radiomics was implemented through feature extraction and Extra Trees Classifier. The DL network is ResNet32. Different input including myocardial ring (DL-myo), myocardial ring bounding box (DL-box) and the surrounding tissue without myocardial ring (DL-nomyo) were tested. We evaluate diagnostic performance through AUC of ROC curve. Accuracy, sensitivity, specificity, ROC, and AUC were calculated. Independent t test, Mann-Whitney U-test and Chi-square test were adopted for HCM and HHD comparison. P < 0.05 was considered statistically significant. DL-myo, DL-box, and DL-nomyo models showed an AUC (95% confidential interval) of 0.830 (0.702-0.959), 0.766 (0.617-0.915), 0.795 (0.654-0.936) in the testing set. AUC of native T1 and radiomics were 0.545 (0.352-0.738) and 0.800 (0.655-0.944) in the testing set. The DL method based on T1 mapping seems capable of discriminating HCM and HHD. Considering diagnostic performance, the DL network outperformed the native T1 method. Compared with radiomics, DL won an advantage for its high specificity and automated working mode. 4 TECHNICAL EFFICACY STAGE: 2.

Distribution of Serum 25-Hydroxyvitamin D Levels in Hypertensive Heart Disease Patients with Atrial Fibrillation in a Secondary Medical Facility in Edo State, Nigeria

Vitamin D deficiency has been implicated in the pathogenesis of hypertension and other cardiovascular diseases which are common risk factors for atrial fibrillation (AF). It also exhibits anti-inflammatory and antioxidant properties. This study aimed to estimate the level of vitamin D in hypertensive heart disease patients who had atrial fibrillation.

46. Relationship between P Wave Dispersion and Left Ventricular Hypertrophy in Hypertensive Heart Disease Patients

Background: It is associated with target-organ damage in various organs and ECG changes. P-wave durations and P-wave dispersion (PWD) are considered to reflect the heterogeneous conduction in atria. Objective: The aim of this study was to investigate relationship PWD and P-wave duration and left ventricular hypertrophy in hypertensive heart disease patients. Method: This study was a-single centre, retrospective study, included 55 consecutive patients with hypertension who had visited the cardiology clinic. Elektrocardiography (ECG) and transthoracal echocardiography (TTE) were performed. Patient were divided into LVH group and control group baed on TTE findings. Patients with valvular regurgitation (moderate or severe), valvular stenosis, myocardial infarction, LV dysfunction, pericardial disease, chronic obstructive pulmonary disease (COPD), bundle branch blocks, atrial fibrillation or flutter were excluded from the study. Results: We found 31 hypertensive patients (56%) had LVH by TTE. The mean age for the HHD was 57 ± 11 years while the control group was 56 ± 11. In the HHD group, maximum P-wave duration was significantly increased at 119.31 ± 13.60 ms, compared to 97.14 ± 18.20 ms in the control group (p &lt; 0.001). There was also a significant increase in minimum P-wave duration in HHD group at 59.65 ± 15.56 ms, compared to control group with 53.33 ± 14.60 ms (p = 0.004). There was a significant increase in the PWD in the hypertensive group at 59.31 ± 19.62 ms, compared to controls with 43.80 ± 17.54 ms (p &lt; 0.001). Conclusion: PWD was significantly increased in hypertensive patient with left ventricular hypertrophy.

33. Association between QT Dispersion and Left Ventricular Hypertrophy in Hypertensive Heart Disease Patients

Background: The variation in QT length reflects regional repolarization differences in the heart. An Increased in QT dispersion is associated with an increased left ventricular mass index in hypertensive individuals. Objective: The aim of this study was to investigate association between QT dispersion and left ventricular hypertrophy (LVH) in hypertensive heart disease (HHD) individuals. Method: This study was a-single centre, retrospective study, included 47 patients with hypertension who had visited the cardiology clinic. Electrocardiography (EKG) and trans-thoracal echocardiography (TTE) were performed. Patients were divided into LVH group (27) and control group (20) based on TTE findings. Patients with valvular abnormalities, myocardial infarction, LV dysfunction, pericardial disease, arrhythmia related, and pulmonary disease were excluded from this study. Results: LVH was diagnosed in 31 (56%) of the patients by 2D echocardiography. The QT interval maximum was higher at 414.00 ± 59.87, than 396.19 ± 37.75 in the control group. Corrected QT (QTc) maximum in HHD group also higher at 448.08 ± 54.83 compared to control group in 421.67 ± 35.61. QT minimum and QTc minimum both are higher in HHD group at 350.40 ± 53.27 and 378.32 ± 43.00 respectively than in controlled group, at 339.05 ± 43.12 and 361.29 ± 45.26. There was no significant association in QT dispersion (p = 0.582) and QTc dispersion (p = 0.265) between HHD group and controlled group. Conclusion: The QT dispersion trend was narrowly higher in hypertensive patient with LVH in HHD group than the controlled group but it was statistically insignificant.

Time to reconsider the perception and management of hypertensive heart disease.

Time to reconsider the perception and management of hypertensive heart disease.

Left Atrial and Ventricular Strain Differentiates Cardiac Amyloidosis and Hypertensive Heart Disease: A Cardiac MR Feature Tracking Study

Strain measured by feature tracking technique represents the degree of deformation and reflects the systolic and diastolic function of the heart. Our purpose was to evaluate the differential diagnostic value and correlations of left atrial (LA) strain (LAS) and left ventricular (LV) strain (LVS) in cardiac amyloidosis (CA) and hypertensive heart disease (HHD) patients. We recruited 25 CA patients, 30 sex- and age-matched HHD patients and 20 healthy subjects totally. LAS and LVS were analyzed by CVI42 post-processing software. The efficiency of LAS and LVS in differentiating CA from HHD was compared by receiver operating characteristic curves analysis. Pearson or Spearman's analysis were used to assess the correlation between LAS and LV parameters. Both HHD and CA patients had impaired LVS, the gradient of increasing absolute values of longitudinal strain (LS) and radial strain (RS) from the basal to the apical myocardium was most pronounced in the CA group, its relative apical sparing of LS (RASLS) ratio reached 0.91 ± 0.02, significantly higher than other two groups (HHD: 0.72 ± 0.02; controls: 0.56 ± 0.01, all p <0.001). Additionally, except for the booster strain in the HHD group was preserved, all other LAS were reduced in patients' groups. The RASLS had the best differential diagnostic efficacy with an area under the curve (AUC) of 0.930 (p <0.001); The AUCs of LAS all greater than 0.850, above global LS (GLS) (AUC=0.770, p=0.001). LAS was notably correlated with LV ejection fraction (LVEF) and GLS, with reservoir strain having the greatest correlation with GLS (r=-0.828, p <0.001). The RASLS has high efficiency in guiding the differential diagnosis of CA and HHD with similar degree and presentation of LVH. Moreover, LAS values can also provide some useful information and they are closely linked with LV function, CMR feature tracking may provide assistance in the evaluation of LA-LV coupling.

Physical activity and the incidence of hypertensive heart disease in patients at Indonesia Hospital in 2022

Background: Hypertensive Heart Disease (HHD) contributes to the increasing burden of cardiovascular disease worldwide and is associated with an increased risk of death. Globally, the prevalence of HHD increased by 137.91% from 7.82 million in 1990 to 19.60 million in 2019. At the national level, China carries the highest prevalence of HHD, followed by the United States and India. Indonesia is ranked 3rd with the highest number of HHD sufferers in the world after China and India based on the DALY (Disability-Adjusted Life Year) level. Lack of physical activity has long been associated with the incidence of HHD. In Indonesia, 33.5% of the population is included in the low physical activity group. The province with the largest percentage of the population who does not do physical activity is DKI Jakarta, where 47.8% of the population does not do physical activity. Methods: This study used an analytical method with a retrospective cross sectional approach. The populations in this study were all HHD patients at the Cardiology Polyclinic of Pasar Rebo Hospital Jakarta with a total sample of 124 respondents. Results: The results of the univariate analysis in this study showed that as many as 69 respondents (55.6%) had low levels of physical activity, 46 respondents (37.1%) had moderate levels of activity, and 9 respondents (7.3%) had high levels of physical activity. The results of the bivariate analysis in this study using the chi square test showed that there was a relationship between physical activity and the incidence of HHD with p value = 0.000 dengan odd Ratio. Keywords: Hypertensive, Hypertensive Heart Disease, Physical Activity

Association between Retinal Microvascular Changes and Severity of Coronary Heart Disease in Hypertensive Patients

Background : The prevalence of coronary artery disease is increasing day by day. In many cases it is undiagnosed. Hypertension is one of the risk factors of coronary artery disease. Hypertension also causes some changes in retina which is easy to diagnose in clinical practice. So the aim of this study is to predict coronary artery disease by seeing hypertensive retinal changes.&#x0D; Methods: A total of 100 patients with hypertension presenting to the emergency department with ischemic chest pain who underwent coronary angiography were studied. Presence or absence of coronary artery disease was determined. Optic fundi were assessed for hypertensive retinopathy which were photographed.&#x0D; Results: Mean ± SD age of the study population was 56.23±10.76 years. There were 75 men (75%) and 25 women (25%). Prevalence of coronary artery disease and hypertensive retinopathy were 84% and 44% respectively. There was association between coronary artery disease and retinopathy (P&lt; 0.017). Age (P= 0.019), smoking (P=0.011) and dyslipidaemia (0.039) were identified as risk factors for coronary artery disease.&#x0D; Conclusion: Important observations from this study are that hypertensive retinopathy has an association with coronary artery disease. Retinal change can be used in predicting coronary artery disease in patients with hypertension which can be used as screening tool for diagnosing coronary artery disease in resource poor settings.&#x0D; University Heart Journal 2022; 18(2): 93- 97

Native T1 mapping for the diagnosis of cardiac amyloidosis in patients with left ventricular hypertrophy

BackgroundCardiac magnetic resonance (CMR) with parametric mapping can improve the characterization of myocardial tissue. We studied the diagnostic value of native T1 mapping to detect cardiac amyloidosis in patients with left ventricular (LV) hypertrophy.MethodsOne hundred twenty-five patients with increased LV wall thickness (≥ 12 mm end-diastole) who received clinical CMR in a 3 T scanner between 2017 and 2020 were included. 31 subjects without structural heart disease served as controls. Native T1 was measured as global mean value from 3 LV short axis slices. The study was registered at German clinical trial registry (DRKS00022048).ResultsMean age of the patients was 66 ± 14 years, 83% were males. CA was present in 24 patients, 21 patients had hypertrophic cardiomyopathy (HCM), 80 patients suffered from hypertensive heart disease (HHD). Native T1 times were higher in patients with CA (1409 ± 59 ms, p < 0.0001) compared to healthy controls (1225 ± 21 ms), HCM (1266 ± 44 ms) and HHD (1257 ± 41 ms). HCM and HHD patients did not differ in their native T1 times but were increased compared to control (p < 0.01). ROC analysis of native T1 demonstrated an area under the curve for the detection of CA vs. HCM and HHD of 0.9938 (p < 0.0001), which was higher than that of extracellular volume (0.9876) or quantitative late gadolinium enhancement (0.9406; both p < 0.0001). The optimal cut-off value of native T1 to diagnose CA was 1341 ms (sensitivity 100%, specificity 97%).ConclusionNon-contrast CMR imaging with native T1 mapping provides high diagnostic accuracy to diagnose cardiac amyloidosis in patients with left ventricular hypertrophy.

Differences in Atrial Remodeling in Hypertrophic Cardiomyopathy Compared to Hypertensive Heart Disease and Athletes' Hearts.

Background: Hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD) and athletes’ heart share an increased prevalence of atrial fibrillation. Atrial cardiomyopathy in these patients may have different characteristics and help to distinguish these conditions. Methods: In this single-center study, we prospectively collected and analyzed electrocardiographic (12-lead ECG, signal-averaged ECG (SAECG), 24 h Holter ECG) and echocardiographic data in patients with HCM and HHD and in endurance athletes. Patients with atrial fibrillation were excluded. Results: We compared data of 27 patients with HCM (70% males, mean age 50 ± 14 years), 324 patients with HHD (52% males, mean age 75 ± 5.5 years), and 215 endurance athletes (72% males, mean age 42 ± 7.5 years). HCM patients had significantly longer filtered P-wave duration (153 ± 26 ms) and PR interval (191 ± 48 ms) compared to HHD patients (144 ± 16 ms, p = 0.012 and 178 ± 31, p = 0.034, respectively) and athletes (134 ± 14 ms, p = 0.001 and 165 ± 26 ms, both p < 0.001, respectively). HCM patients had a mean of 4.9 ± 16 premature atrial complexes per hour. Premature atrial complexes per hour were significantly more frequent in HHD patients (27 ± 86, p < 0.001), but not in athletes (2.7 ± 23, p = 0.639). Left atrial volume index (LAVI) was 43 ± 14 mL/m2 in HCM patients and significantly larger than age- and sex-corrected LAVI in HHD patients 30 ± 10 mL/m2; p < 0.001) and athletes (31 ± 9.5 mL/m2; p < 0.001). A borderline interventricular septum thickness ≥13 mm and ≤15 mm was found in 114 (35%) HHD patients, 12 (6%) athletes and 3 (11%) HCM patients. Conclusions: Structural and electrical atrial remodeling is more advanced in HCM patients compared to HHD patients and athletes.

Abstract 12957: Determining Disease Co-Occurrence Architecture of Hypertensive Heart Disease in Penn Medicine Biobank Using Longitudinal EHR Data Linked With PMBB Participants

An estimated 1.2 billion individuals worldwide suffer from hypertension. Hypertensive heart disease (HHD) refers to structural alterations, such as left ventricular hypertrophy in the heart due to prolonged hypertension and can lead to ischemic heart disease, heart failure, and arrhythmias. HHD represents a transitory subclinical condition between the onset of hypertension and cardiovascular disease, typically remaining asymptomatic until the time of adverse cardiac event. The risk of HHD-related diseases is heightened due to hypertension-associated comorbidities such as dyslipidemia and renal failure. The complex etiology underlying HHD makes it challenging to predict outcomes in patients. The goal of this study is to leverage longitudinal electronic health record (EHR) data to identify the conditions and comorbidities that influence HHD outcomes for prognostication. We defined an HHD patient cohort (n = 4,268) in the Penn Medicine BioBank dataset using diagnosis code ICD-10: I11* for HHD. We constructed a disease-disease map of HHD comorbidities using the Ising model, a type of Markov Random Field undirected probabilistic graphical model. We estimated the co-occurrence of disease pairs by calculating pairwise similarities between diseases as relative risk and conducting network analyses. Our results reflect clusters of known disease-disease connections, including interactions between endocrine and nervous system diseases, as well as novel pairwise disease interactions between genitourinary and musculoskeletal diseases. Our findings shed light on the effect of comorbid conditions on the trajectory of HHD adverse outcomes. Using the probabilistic model of disease co-occurrence from these results, we can identify key comorbidities that predict adverse outcomes among HHD patients. This work lays the foundation to integrate rare and common genetic variants into the Ising model using a gene-based binning approach. Incorporating rare loss-of-function variants will enable us to evaluate shared genetic connections between HHD comorbidities. In conclusion, we used EHR data to identify the genetic and non-genetic connections between comorbidities of HHD to develop a predictive metric for the prevention and clinical monitoring of HHD.

Left atrial strain analysis in hypertensive heart disease and hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking

Abstract Funding Acknowledgements Type of funding sources: None. Background Increasing evidence suggests that left atrial (LA) deformation is a sensitive marker of diastolic dysfunction in hypertrophic phenotypes. However, there is little data about the impact of hypertension on LA function; furthermore, LA deformation in hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) has not been compared yet. Purpose The aim of this study is to compare atrial dimensions and function, evaluated by cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with HHD, HCM and healthy subjects (HS). Methods 67 patients (20 HHD, 27 HCM, 20 HS) underwent CMR and were included in the study. Patients were matched for age, sex and BSA; HHD and HCM were also comparable for LV mass index and ejection fraction (EF). CMR-FT atrial strain analysis was performed using Qstrain, Medis software to obtain i) LA conduit function, ii) LA booster pump function), iii) LA reservoir function, iv) LA volumes and EF. Tissue Doppler echocardiography was used to assess diastolic function, including E/e’. LA stiffness was calculated as the ratio between E/e’ and LA reservoir. Both focal and interstitial myocardial fibrosis were assessed with LGE and extracellular volume (ECV) quantification. Results HHD and HCM showed impaired LA reservoir, conduit function and higher LA volumes vs HS (reservoir: 28 ± 11% and 28 ± 13% vs 41 ± 17%; conduit: 13 ± 7% and 13 ± 7% vs 22 ± 11%; LAESV: 76 ± 21 and 87 ± 22 vs 57 ± 19 ml respectively; all p ≤ 0.03). HHD and HCM were comparable for bi-ventricular morpho-functional parameters and ECV. HHD showed lower E/e’ values (8 ± 2 vs 16 ± 7, p = 0.002) and LA stiffness (0.23 ± 0.3 vs 0.74 ± 0.6, p 0.03), LA dimensions (LA area 13 ± 3 vs 16 ± 3 cm2/m2, p = 0.02 , LAESVi 41 ± 12 vs 48 ± 11 ml/m2, p = 0.05) and LGE extent (1 ± 2% vs 5 ± 5%, p = 0.001) as compared to HCM. Interestingly, HHD revealed a comparable reduced LA reservoir and conduit function (all p = 0.9) vs HCM. In HHD patients LA reservoir function was correlated with E/e’ (r -0.8, p = 0.02), but not in HCM. Conversely, LA reservoir function was correlated with LV mass index in HCM (r -0.5, p &amp;lt; 0.01). Conclusions HHD patients showed a similar and significant impairment of LA function, with lower LA dimensions and E/e’ compared to HCM with similar LV mass index and preserved function. CMR-FT atrial strain analysis could represent a useful tool for HHD management, able to detect diastolic dysfunction (and/or atrial dysfunction) earlier than traditional markers. Further studies are needed to explore the relationship of LA deformation to heart failure symptoms and atrial fibrillation occurrence and potential changes related to response to therapy.

53. LV FILLING PRESSURE IN PATIENT WITH HYPERTENSIVE HEART DISEASE

Background: Patient with Hypertensive Heart Disease (HHD) could develop asymptomatic LV dysfunction, and when LV diastolic function is impaired, the patient could have heart failure even with preserved LV ejection fraction. Assessment of left ventricular filling pressure is indicator of LV diastolic dysfunction in HHD patients. Objective: To evaluate LV filling pressure of HHD patient in outpatient clinic of M. Djamil Hospital Padang. Methods: We collect data of 170 HHD patients during 2018–2019 who met inclusion criteria. Subject were categorized based on LV geometric pattern. LV filling pressure was determined from mitral velocity inflow (E/A ratio) and left atrial volume index (LAVI). Statistical analysis was performed using SPSS. Results: Most subject were female (n = 52.9%), mean age was 59.06 ± 10.5 years and no significant difference of age between groups (p = 0.36). The most LV geometric pattern was LV concentric hypertrophy (CH) (n = 60.58%). Only 10.6% subjects were symptomatic. Mean E/A ratio was 0.94 ± 0.2, highest value was in LV eccentric hypertrophy (EH) group (0.95 ± 0.3), but no significant difference between group (p = 0.603). There was significant difference of LAVI between groups (p = 0,007) with EH group have the highest value (mean 35.2 ± 12.0 ml/m2). No difference of diastolic dysfunction (p = 0.42). Conclusion: Majority of subject in this study were asymptomatic and have CH geometric pattern. LV filling pressure was not showed significantly from E/A ratio analysis. There was significant difference of LAVI with EH group have more higher LAVI value that showed increased LV filling pressure.

Poster: Cardiovascular magnetic resonance analysis for discrimination between hypertensive heart disease and hypertrophic cardiomyopathy

It may be difficult to differentiate hypertrophic cardiomyopathy (HCM) from hypertensive heart disease (HHD) especially when left ventricular wall thickness (LVWT) ≥ 15 mm. Because cardiovascular magnetic resonance (CMR) has emerged as an efficient technique to characterise morphologic, functional and tissue abnormalities, we investigate the discriminatory capacity of this technique by analysing different imaging markers in HCM and in HHD. A total of 60 HCM patients (group 1) and 60 HHD subjects with left ventricular wall thickness ≥ 15 mm without ischemic or other cardiac pathology (group 2) underwent CMR. No differences were noted between the 2 groups with regards to mean ages, BMI, gender and creatinine clearance. The 2 groups had similar indexed LV mass (group 1: 107 ± 11 g/m 2 vs. group 2: 104 ± 13 g/m 2 , P > 0.05) but patients with HCM had higher LVWT compared with HHD patients (21.5 ± 3 mm vs. 16.3 ± 1.2 mm, P < 0.001). Complete systolic anterior motion of the mitral valve (SAM) was frequent in group 1 patients while totally absent in group 2 (38% vs. 0%, P < 0.0001). Late gadolinium enhancement (LGE) was significantly predominant in HCM patients (76% vs. 14%, P < 0.0001). Compared with HHD group, native T1 was also significantly higher in HCM patients (1181 ± 36 ms vs. 1048 ± 40 ms, P < 0.001). In multivariate analysis, presence of SAM and native T1 remained significant predictors of HCM. These observations underscore the important role for CMR in the assessment of patients with HCM. CMR has several tools providing novel information in accurate discrimination between HCM and hypertensive heart disease.

Texture analysis applied in T1 maps and extracellular volume obtained using cardiac MRI in the diagnosis of hypertrophic cardiomyopathy and hypertensive heart disease compared with normal controls

To assess the potential of texture analysis (TA) applied in T1 maps and extracellular volume (ECV) obtained using cardiac magnetic resonance (CMR) in the diagnosis of hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) compared with normal controls (NC). Strain parameters were analysed to compare with final TA models. This retrospective study included 66 HCM patients, 39 HHD patients, and 41 NC. Step-wise dimension reduction and feature selection were performed by reproducibility, machine learning, collinearity, and multivariable regression analysis to select the texture features that enable diagnosis of and differentiation between HCM and HHD. Strain parameters were calculated by short-axis and three long-axis cine sequences. Independent features in T1 maps and ECV analysis allowed for the differentiation between patients (HCM and HHD) and NC. Of the best-calculated model, the areas under the receiver operating curve (AUCs) were as follows: 0.969 for T1 map and 0.964 for ECV. To distinguish HCM from HHD, two independent features were screened out for both T1 and ECV maps. The AUCs were as follows: 0.793 for T1 map and 0.894 for ECV. Radial, circumferential, and longitudinal strain parameters could differentiate patients from NC, but only longitudinal strain parameters was significantly different between HCM and HHD. Texture analysis of T1 maps and ECV shows high accuracy in differentiating hypertrophic myocardium from NC, and HCM from HHD. Strain parameters are able to demonstrate the difference between patients and NC, but were less impressive in differentiating HCM and HHD.

Phenotyping of hypertensive heart disease and hypertrophic cardiomyopathy using personalized 3D modelling and cardiac cine MRI.

Differential diagnosis of hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) is clinically challenging but important for treatment management. This study aims to phenotype HHD and HCM in 3D+time domain by using a multiparametric motion-corrected personalized modeling algorithm and cardiac magnetic resonance (CMR). 44 CMR data, including 12 healthy, 16 HHD and 16 HCM cases, were examined. Multiple CMR phenotype data consisting of geometric and dynamic variables were extracted globally and regionally from the models over a full cardiac cycle for comparison against healthy models and clinical reports. Statistical classifications were used to identify the distinctive characteristics and disease subtypes with overlapping functional data, providing insights into the challenges for differential diagnosis of both types of disease. While HCM is characterized by localized extreme hypertrophy of the LV, wall thickening/contraction/strain was found to be normal and in sync, though it was occasionally exaggerated at normotrophic/less severely hypertrophic regions during systole to preserve the overall ejection fraction (EF) and systolic functionality. Additionally, we observed that hypertrophy in HHD could also be localized, although at less extreme conditions (i.e. more concentric). While fibrosis occurs mostly in those HCM cases with aortic obstruction, only minority of HHD patients were found affected by fibrosis. We demonstrate that subgroups of HHD (i.e. preserved and reduced EF: HHDpEF & HHDrEF) have different 3D+time CMR characteristics. While HHDpEF has cardiac functions in normal range, dilation and heart failure are indicated in HHDrEF as reflected by low LV wall thickening/contraction/strain and synchrony, as well as much reduced EF.