Bioscience Methods 2024, Vol.15, No.3, 124-138 http://bioscipublisher.com/index.php/bm 127 3 Traditional Diagnostic Approaches for HHD 3.1 Non-invasive techniques (e.g., ECG, Echocardiography) Non-invasive diagnostic techniques are pivotal in the initial assessment and ongoing management of hypertensive heart disease (HHD). Among these, electrocardiography (ECG) and echocardiography are the most commonly utilized tools. Electrocardiography (ECG): ECG is a widely accessible and cost-effective method for detecting cardiac abnormalities associated with HHD. It can identify left ventricular hypertrophy (LVH), a hallmark of HHD, through specific voltage criteria and patterns. However, the sensitivity of ECG for detecting LVH is relatively low, which limits its utility as a standalone diagnostic tool (Ojji et al., 2020). Despite this limitation, ECG remains valuable for its ability to provide immediate information on cardiac electrical activity and to identify other potential complications such as arrhythmias (Dimopoulos et al., 2018). Echocardiography: Echocardiography is the first-line imaging modality for evaluating cardiac structure and function in hypertensive patients. It provides detailed information on left ventricular mass, wall thickness, and systolic and diastolic function. Advanced echocardiographic techniques, such as speckle-tracking echocardiography, allow for the assessment of myocardial strain, which can detect subclinical myocardial dysfunction before overt symptoms appear (Tadic et al., 2022). Additionally, three-dimensional echocardiography offers precise volumetric measurements, enhancing the accuracy of cardiac assessments (Schumann et al., 2019). Echocardiography is also instrumental in differentiating HHD from other conditions like heart failure with preserved ejection fraction (HFpEF) by evaluating parameters such as global longitudinal strain (GLS) and extracellular volumez (ECV) (Mordi et al., 2017). 3.2 Invasive techniques (e.g., Cardiac catheterization) Invasive diagnostic techniques, although less commonly used due to their higher risk and cost, provide definitive information that can be crucial in certain clinical scenarios. Cardiac Catheterization: Right-heart catheterization is considered the gold standard for measuring pulmonary artery pressures and diagnosing pulmonary hypertension (PH), which can be a complication of HHD. This procedure involves the insertion of a catheter into the right side of the heart and pulmonary arteries to directly measure pressures. Despite its accuracy, the invasiveness and associated risks, such as bleeding and infection, limit its routine use (Tsujimoto et al., 2022). Cardiac catheterization is typically reserved for cases where non-invasive methods yield inconclusive results or when precise hemodynamic measurements are necessary for therapeutic decision-making (Kovacs et al., 2016). 3.3 Limitations of conventional methods While traditional diagnostic approaches for HHD, including ECG, echocardiography, and cardiac catheterization, are invaluable, they have several limitations. Sensitivity and Specificity: ECG, although widely used, has limited sensitivity for detecting LVH and other structural changes in the heart. This can lead to underdiagnosis or delayed diagnosis of HHD (Ojji et al., 2020). Echocardiography, while more sensitive than ECG, can still miss early or subtle changes in myocardial structure and function, particularly in the presence of obesity or poor acoustic windows (Tadic et al., 2022). Invasiveness and Risk: Cardiac catheterization, despite its accuracy, is invasive and carries risks such as bleeding, infection, and vascular complications. These risks make it unsuitable for routine screening and limit its use to specific clinical indications (Tsujimoto et al., 2022). Cost and Accessibility: Advanced imaging techniques like cardiac magnetic resonance (CMR) and three-dimensional echocardiography, although highly informative, are expensive and not widely available in all healthcare settings. This can limit their use, particularly in resource-limited environments (Schumann et al., 2019; Ojji et al., 2020).
RkJQdWJsaXNoZXIy MjQ4ODY0NQ==