Assessing cardiac contractility in hypertension with heart failure with preserved ejection fraction: the value of left ventricular strain
Bibliographic record
Abstract
Aim: Hypertension (HTN) is a major cause of heart failure but the precise pathways by which HTN leads to heart failure are not resolved. Newer echocardiographic techniques permit assessment of myocardial contraction in different orientations defining left ventricular (LV) shortening as percentage longitudinal, circumferential and radial strain. Methods: A systematic search was conducted of Medline and Embase. The search was conducted from the inception of each database on June 30, 2022. Search terms “left ventricular strain” or speckle tracking AND heart failure with preserved ejection fraction or diastolic dysfunction AND HTN. Results: Six studies were identified and subject to detailed review. LV ejection fraction (LVEF) was not significantly different in patients with heart failure with preserved ejection fraction (HFpEF) and HTN compared to individuals with or without HTN. Global longitudinal strain (GLS) and global circumferential strain (GCS) were significantly (P < 0.0001) different (lower) in patients with HFpEF and HTN compared to patients with HTN without HFpEF and control individuals without HTN or other conditions. In contrast, global radial strain (GRS) was not significantly (P < 0.054) different in patients with HFpEF and HTN compared to individuals without HTN or other conditions. GRS was significantly (P < 0.01) different in individuals with HFpEF and HTN compared to individuals with HTN. Conclusions: Assessment of LV strain is an important advance in the assessment of LV function in patients with HTN and HFpEF as it identifies patients with reduced LV strain while there was no difference in LVEF. GLS and GCS provide the best separation between patients with HFpEF and HTN compared to individuals with HTN without HFpEF. This study advances the possibility of redefining the classification of heart function and heart failure for patients with HTN by either classifying patients mainly by LV strain or sub-classifying patients with HTN and HFpEF by LV strain.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".