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- Title
Ethnicity differences in geometric remodelling and myocardial composition in hypertension unveiled by cardiovascular magnetic resonance.
- Authors
Georgiopoulos, Georgios; Faconti, Luca; Mohamed, Aqeel T; Figliozzi, Stefano; Asher, Clint; Keehn, Louise; McNally, Ryan; Alfakih, Khaled; Vennin, Samuel; Chiribiri, Amedeo; Lamata, Pablo; Chowienczyk, Philip; Masci, Pier-Giorgio
- Abstract
Aims Hypertensive patients of African ancestry (Afr-a) have higher incidences of heart failure and worse clinical outcomes than hypertensive patients of European ancestry (Eu-a), yet the underlying mechanisms remain misunderstood. This study investigated right (RV) and left (LV) ventricular remodelling alongside myocardial tissue derangements between Afr-a and Eu-a hypertensives. Methods and results 63 Afr-a and 47 Eu-a hypertensives underwent multi-parametric cardiovascular magnetic resonance. Biventricular volumes, mass, function, mass/end-diastolic volume (M / V) ratios, T2 and pre-/post-contrast T1 relaxation times, synthetic extracellular volume, and myocardial fibrosis (MF) were measured. 3D shape modelling was implemented to delineate ventricular geometry. LV and RV mass (indexed to body-surface-area) and M/V ratio were significantly greater in Afr-a than Eu-a hypertensives (67.1 ± 21.7 vs. 58.3 ± 16.7 g/m2, 12.6 ± 3.48 vs. 10.7 ± 2.71 g/m2, 0.79 ± 0.21 vs. 0.70 ± 0.14 g/mL, and 0.16 ± 0.04 vs. 0.13 ± 0.03 g/mL, respectively; P < 0.03). Afr-a patients showed greater basal interventricular septum thickness than Eu-a patients, influencing LV hypertrophy and RV cavity changes. This biventricular remodelling was associated with prolonged T2 relaxation time (47.0 ± 2.2 vs. 45.7 ± 2.2 ms, P = 0.005) and higher prevalence (23% vs. 4%, P = 0.001) and extent of MF [2.3 (0.6–14.3) vs. 1.6 (0.9–2.5) % LV mass, P = 0.008] in Afr-a patients. Multivariable linear regression showed that modifiable cardiovascular risk factors and greater end-diastolic volume, but not ethnicity, were independently associated with greater LV mass. Conclusion Afr-a hypertensives had distinctive biventricular remodelling, including increased RV mass, septal thickening and myocardial tissue abnormalities compared with Eu-a hypertensives. From this study, modifiable cardiovascular risk factors and ventricular geometry, but not ethnicity, were independently associated with greater LV myocardial mass.
- Subjects
LEFT heart ventricle; CROSS-sectional method; PEARSON correlation (Statistics); STATISTICAL models; AFRICAN Americans; RESEARCH funding; T-test (Statistics); DATA analysis; VENTRICULAR remodeling; HYPERTENSION; MULTIPLE regression analysis; FISHER exact test; BODY composition; MAGNETIC resonance imaging; CARDIOVASCULAR diseases risk factors; MANN Whitney U Test; CHI-squared test; DESCRIPTIVE statistics; LEFT ventricular hypertrophy; MYOCARDIUM; STATISTICS; INTRACLASS correlation; RIGHT heart ventricle; DIGITAL image processing; DATA analysis software; CONFIDENCE intervals; ANTHROPOMETRY; EUROPEAN Americans; BLOOD pressure measurement
- Publication
European Heart Journal - Cardiovascular Imaging, 2024, Vol 25, Issue 7, p901
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jeae097