Layer-specific quantification of myocardial deformation may disclose the subclinical systolic dysfunction and the mechanism of preserved ejection fraction in patients with hypertension
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AbstractBackground: Systemic hypertension (HTN) leads to left ventricular (LV) remodeling, which results in diastolic dysfunction in the presence of preserved ejection fraction (EF). The goal of this study was to explore subclinical LV systolic dysfunction and the mechanism of preserved EF using layer-specific quantification of myocardial deformation in HTN patients. Methods: One hundred and twenty HTN patients (mean blood pressure (BP) 165±20/ 96±16mmHg) and 120 age and gender matched volunteers (mean BP 120 ± 10/76± 8 mmHg) were studied. Left ventricular echocardiographic parameters including LV ejection fraction (LVEF), global and regional peak longitudinal, circumferential 2D systolic layer strain and LV twistweremeasured. The associations between these parameterswere studied against LV relative wall thickness (RWT) and LV mass index. Results: LVEF was normal in all HTN patients. TheRWT and LVmass index were higher in HTN group (0.40±0.06 vs 0.35 ± 0.03, p < 0.0001; 84 ± 24 vs 63 ± 11 g/m2, p b 0.0001). The absolute value of layer and global longitudinal strain was significantly lower in HTN group (-24 ± 3 vs -26 ± 3%, p < 0.0001;. 21 ± 3 vs -23 ± 3%, p b 0.0001, respectively). Global circumferential strain (-40± 6 vs-35± 5%,-31± 7 vs-27± 4% respectively, p < 0.0001), and the LV twist (23 ± 5 vs 18 ± 6 degree, p < 0.0001) were higher in HTN group. Conclusions: This study revealed that hypertension resulted in increased RWT and LV mass. Impairment in layer and global longitudinal strain found in HTN patients may indicate early systolic dysfunction due to impaired endomyocardial function. Enhancement of circumferential strain and LV twist may be a compensatory mechanism to maintain LVEF in these patients.
All Author(s) ListSun J.P., Xu T., Yang Y., Yang X.S., Shang Q., Li Y., Wang J., Yan B.P.
Journal nameInternational Journal of Cardiology
Volume Number219
PublisherElsevier BV
Place of PublicationNetherlands
Pages172 - 176
LanguagesEnglish-United Kingdom
KeywordsCardiac function, Hypertension, Layer-specific speckle tracking

Last updated on 2021-12-09 at 23:47