The assessment of echoreflectivity for the detection of myocardial fibrosis in hypertensive patients
The aim of the study was to improve the diagnosis of structural and functional changes of the heart in patients with hypertension by studying of some indicators of echoreflectivity. 90 hypertensive males aged from 45 to 65 years without irreversible target organ damages were enrolled. They were divided into 3 groups of 30 persons depending on the stages of hypertension according to ESC recommendations (2013). Control group consisted of 30 males of the same age without history of hypertension and any abnormality revealed by echocardiography. Office blood pressure measurement, standard echocardiography were performed in all patients. Echoreflectivity parameters were obtained with "ImageJ" software by the analysis of distribution of black and white pixels of the images from parasternal long axis view of the left ventricle. We analyzed such parameters as Broad Band (BB), Kurtosis (K), Skewness (Sk) and mean color scale value (mCS). The results showed not only the myocardial mass and relative wall thickness, but also myocardial echoreflectivity changed with the rising stage of hypertension. Based on our data, the narrowing of the range of the spectrum of the reflected signal - BB was the main indicator of echoreflectivity changes. Also it was found that the sensitivity of echoreflectivity analysis in early stages of essential hypertension was higher than the mitral flow Doppler. That's why the assessment of echoreflectivity could be recommended as a supplement to the standard echocardiographic examination.