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Rivista sulle Malattie del Cuore e dei Vasi

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


lingua: Inglese

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


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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