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MINERVA CARDIOANGIOLOGICA

A Journal on Heart and Vascular Diseases


Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2017 Apr 10

DOI: 10.23736/S0026-4725.17.04390-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Cardiac imaging in patients with arterial hypertension

Francesco ANTONINI-CANTERIN 1, 2, Elisa LEIBALLI 2, Flavia MARTINIS 1, 2 , Daniela PAVAN 2

1 U.O. Cardiologia Riabilitativa di Sacile, CRO di Aviano, Aviano, Pordenone, Italy; 2 Dipartimento di Cardiologia AAS5 Friuli Occidentale, Pordenone, Italy


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Hypertension is considered the major modifiable risk factor for premature cardiovascular disease, being more common than other important risk factors as cigarette smoking, dyslipidemia, or diabetes [1]. In older patients, systolic pressure and pulse pressure are more powerful determinants of cardiovascular events than diastolic pressure [2]. Importantly, the cardiovascular risk associated with hypertension is significantly affected by the presence or absence of other major risk factors [3]. Among imaging features, left ventricular hypertrophy (LVH) is the more common and early in patients with hypertension [4]. LVH is a well recognized marker of mortality, heart failure, myocardial infarction, sudden death, and stroke [5]. The risk of heart failure, both “systolic” (with reduced ejection fraction) and “diastolic” (with preserved or mildly reduced ejection fraction), increases with the degree of blood pressure elevation [6]. Conventional echocardiography is the most common and used imaging technique and can detect anatomical and functional changes easily in a real-time, quick, non invasive and relatively unexpensive manner. It is well known that echocardiography is more sensitive than electrocardiography for the detection of asymptomatic organ damage [7]. Other imaging techniques, such as magnetic resonance imaging (MRI) and 3-D echocardiography gained an increasing role in selected patients, as well as the study of arterial stiffness, also using ultrasonographic echo-tracking methods.

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