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European Journal of Echocardiography 2007 8(1):42-47; doi:10.1016/j.euje.2006.02.001
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Copyright © 2006, The European Society of Cardiology

Do women have impaired regional systolic function in hypertensive heart disease? A 3-dimensional echocardiography study

Jürgen Frielingsdorfa,*, Michele Genonia, Otto M. Hessb and Frank A. Flachskampfc

aHeart Center, City Hospital Triemli, Birmensdorferstrasse 497, 8063 Zürich, Switzerland
bCardiology, University Hospital, Bern, Switzerland
cMedical Clinic II, University Hospital, Erlangen, Germany

Received 26 August 2005; received in revised form 20 January 2006; accepted after revision 1 February 2006.

* Corresponding author. Tel.: +41 1 466 1313; fax: +41 1 466 2599. juergen.frielingsdorf{at}triemli.stzh.ch


  Abstract

Aims In pressure overload left ventricular (LV) hypertrophy, gender-related differences in global LV systolic function have been previously reported. The goal of this study was to determine regional systolic function of the left ventricle in male and female patients with hypertensive heart disease.

Methods and results Regional LV function was analyzed from multiplane transesophageal echocardiography with three-dimensional (3D) reconstruction of the left ventricle. In 24 patients (13 males and 11 females), four parallel (2 basal and 2 apical) equidistant short axis cross-sections from base to apex were obtained from the reconstructed LV. In each short axis 24 wall-thickness measurements were carried out at 15° intervals at end-diastole and end-systole. Thus, a total of 192 measurements were obtained in each patient. Wall thickening was calculated as difference of end-diastolic and end-systolic wall thickness, and fractional thickening as thickening divided by end-diastolic thickness.

Fractional thickening and wall stress were inversely related to end-diastolic wall thickness in both, males and females. Females showed less LV systolic function when compared to males (p<0.001). However, when corrected for wall stress, which was higher in females, there was no gender difference in systolic function.

Conclusion There are regional differences in LV systolic function in females and males which are directly related to differences in wall stress. Thus, gender-related differences in LV regional function are load-dependent and not due to structural differences.

Keywords: Hypertension; Left ventricular hypertrophy; Regional systolic function; Wall stress; Wall thickness; Three-dimensional echocardiography


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