Assessment of the study of longitudinal systolic function by 2D strain in hypertensive patients
Authors: Taleb Bendiab N , Benkhedda S , Meziane Tani A 
Published: July 2021

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): University Hospital Center of Tlemcen

Introduction

Hypertension is a well-established risk factor for cardiovascular disease. It causes left ventricular (LV) pressure overload, and, changes in cardiac geometry and LV hypertrophy(LVH).

LVH as well as patterns of abnormal geometry have been associated with adverse outcomes. 

Global longitudinal strain (GLS) has been used to detect early subclinical myocardial dysfunction in a broad spectrum of cardiac conditions and thereby provides a novel approach for LV risk assessment in patients with hypertension.

Purpose

This study is intended to assess the clinical and echocardiographic factors associated with and predictive for early impairment of left ventricular function as assessed using GLS evaluation in hypertensive patients.

Methods

Cross-sectional descriptive study, with a total number of 130 hypertensive and with the objective of evaluating the study of longitudinal function by 2D strain in patients with systemic hypertension with preserved LVEF and the determination of predictors the decrease GLS in this population. A complete study echo cardiographic, including LVEF biplane Simpson method, calculation of left ventricular mass indexed and relative parietal thickness to differentiate the eccentric and concentric LVH, analysis diastolic function and finally the study of longitudinal strain of the LV by the speckle tracking technique (calculation of GLS) to seek a possible decline in the GLS and establish a possible correlation between this drop and power and LVH the diagnosis of subclinical hypertensive heart disease.

Results

The prevalence of left ventricular hypertrophy (LVH) was found in (66%) in this population. half of the patients (49%) presented a concentric hypertrophy, It was clearly noted that 73%of the patients had a relative wall thickness (RWT)&gt;0.42. Alterations in diastolic function were detected in 89% of the group, 18% had severe diastolic dysfunction with elevation in filling pressure. Analysis of the longitudinal systolic function of the left ventricle took the average GLS as a reference value. The mean GLS was found to be -16.9 ± 3.2%, within a range between -25% and-11.6%.

Low GLS values (&gt;-17%) were found in 45.5% of the general population. In particular, 34.4% of the patients had no left ventricular hypertrophy (LVH) and 50.7% of them presented LVH.

The average systolic and diastolic blood pressures, taken at the time of echocardiographic analysis, were found higher in the subgroup of hypertensive patients with low GLS.

Very low GLS values (&gt;-13%) were found in 11% of the general population.

Statistical analysis revealed  significant correlation between the decrease in GLS and diabetes the values of blood pressure and elevated filling pressures.

Conclusion

 The evaluation of longitudinal systolic function  provides new insight of myocardial function in hypertension that could improve the pathophysiological understanding and identify high-risk heart failure patients eligible for preventive strategies.