Myocardial work: impact of essential hypertension

Abstract Background Myocardial work (MW) is an advanced echocardiographic tool that evaluates left ventricular (LV) function by integrating afterload and myocardial deformation. Hypertension (HTN), a major cardiovascular risk factor, is associated with LV remodeling and dysfunction. This study aimed to characterize global MW indices in hypertensive and non-hypertensive individuals. Methods A retrospective, single-center study was conducted, including patients without known cardiovascular disease who underwent MW assessment between January 2022 and November 2024. Echocardiographic parameters, including global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE), were analyzed. Patients were stratified by hypertension status (HTN diagnosis and elevated blood pressure [BP] during the exam). LV remodeling patterns (concentric remodeling [CR] vs. left ventricular hypertrophy [LVH]) were also evaluated. Multivariate analyses adjusted for age and sex identified predictors of MW parameters. Results Among 822 patients (43.7% with HTN), hypertensive individuals exhibited more cardiovascular risk factors, higher resting BP, greater LV remodeling (CR and LVH), and larger left atrial volumes (all p0.05), and LV remodeling patterns did not significantly influence MW indices. However, patients with elevated resting BP (≥140/90 mmHg) demonstrated significantly higher GWI, GCW, and GWW (p