Early predictors of left ventricular dysfunction in hypertensive patients: comparative cross-section study

Shehata, Islam Elsayed; Eldamanhory, Ahmed Said

doi:10.1007/s10554-020-01790-z

Cited by 13 publications

(12 citation statements)

References 30 publications

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“…After the initial screening of titles and abstracts, 780 studies were excluded as they did not assess the relation between LV systolic dysfunction and systemic hypertension. Therefore, 110 studies were reviewed; of these, 22 studies fulfilled the inclusion and exclusion criteria and contained sufficient clinical and echocardiographic data to be included in the final review [14–35] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies

Tadić

Sala

Carugo

et al. 2021

Journal of Hypertension

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Available evidence on systolic dysfunction in systemic hypertension, as assessed by left ventricular (LV) mechanics, is still based on single studies. Thus, we performed a systematic meta-analysis of two-dimensional speckle-tracking studies in order to provide an updated comprehensive information on this issue. Methods:The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English language articles published from the inception up to 31 December 2020. Studies were identified by using MeSH terms and crossing the following search items: 'myocardial strain', 'left ventricular mechanics', 'speckle tracking echocardiography', 'systolic dysfunction', 'hypertensive heart disease', 'systemic hypertension', 'essential hypertension'.Results: Data from 4276 individuals (2089 normotensive controls and 2187 mostly uncomplicated hypertensive patients) were included. Left ventricular (LV) mass index, relative wall thickness, left atrial volume index and E/e' ratio were significantly higher in hypertensive patients than in normotensive controls. LV ejection fraction did not differ in the two pooled groups (SMD À0.048 AE 0.054, 95% CI À0.20 to 0.10, P ¼ 0.30), whereas LV global longitudinal strain (GLS) was significantly impaired in the hypertensive group (SMD: 1.07 AE 0. 15, 95% CI 0.77-1.36, P < 0.0001). Similar findings were obtained in a subanalysis restricted to 15 studies in which mean age was similar in cases and controls (SMD 1.21 AE 0.23, 95% CI 0.76-1.67, P ¼ 0.002). Conclusion:The present meta-analysis suggests that GLS assessment unmasks systolic dysfunction undetected by conventional ejection fraction in the uncomplicated hypertension setting and that this parameter should be incorporated into routine work-up aimed to identify hypertension-mediated cardiac damage.

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Section: Resultsmentioning

confidence: 99%

Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies

Tadić

Sala

Carugo

et al. 2021

Journal of Hypertension

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“…In the hypertensive group, however, the E/E′ ratio was much larger. Also, the study by Shehata et al 16 reported that in hypertension individuals, E′ velocity was substantially decreased. In the hypertensive group, however, the E/E′ ratio was much larger.…”

Section: Discussionmentioning

confidence: 95%

Assessment Of Left Ventricular Systolic Function By Speckle Tracking Echocardiography In Young Hypertensive Patients

Allah

Noah

Shokr

2022

Al-Azhar International Medical Journal

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Background: Tissue Speckle Tracking examines speckle aberrations in an echo picture to determine myocardial contractility and relaxation. Reflections, refraction, and dispersion of echo beams generate speckles. Aim of the study: The purpose of this research was to use speckled tracking echocardiography to identify subclinical left ventricular failure in young hypertension individuals who had normal systolic function by 2D echocardiography. Patients and Methods: The research included 30 hypertensive patients with preserved ejection fraction referred to cardiology department at AL azhar University hospital for echocardiography assessment and 20 controls. All patients were assessed clinically followed by M-Mode and 2D echocardiography assessment, pulsed wave Doppler mitral inflow as well as offline speckle tracking echocardiography.Result: Demographic data, anthropometric measurements, blood pressure measurements, conventional tissue Doppler, and strain echocardiography were compared between the two groups. Body mass index, systolic and diastolic blood pressure, left ventricular end diastolyic dimension, interventricular septal diameter, posterior wall diameter, relative wall thickness, left ventricular mass index, end diastolic volume, E/, left atrial diameter, aortic diameter, left atrial volume index, normal systolic velocity of tissue doppler mitral inflow, and GLS. The control group had a considerably greater systolic velocity (p=0.013). In comparison to the hypertension group, GLS was considerably greater in the control group (-21.25± 1.18 vs -19.18±1.66, p=0.001). Conclusion:The final result of the research recommends comprehensive longitudinal stress assessment and tissue Doppler imaging for all newly discovered arterial hypertension patients or patients with arterial hypertension who have normal ejection fraction and suffer from shortness of breath.

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“…Variations in conventional ultrasound parameters and increased LVMI suggested LV remodeling occurred but LVEF was normal in the hypertensive patients. A previous study 19 found a significant correlation between E/e ratio and global longitudinal strain (GLS) suggesting both systolic and diastolic impairments exist in patients with hypertension. More rewardingly we found the E/e ratio in hypertensive patients increased during exercise, which predicates compromised diastolic reserve function.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of left ventricular function by treadmill exercise stress echocardiography combined with layer‐specific strain technique in essential hypertension patients

Wang

Zhang

et al. 2022

J of Clinical Hypertension

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The purpose of this study was to evaluate the diagnostic utility of treadmill exercise stress echocardiography (TESE) combined with left ventricular (LV) layer-specific strain (LSS) in subclinical myocardial and reserve function of hypertensive patients.A total of 55 hypertensive patients and 51 controls were evaluated during rest and exercise. Two-dimensional speckle tracking (2DST) and LSS technique was used to measure longitudinal and circumferential strains at rest and peak exercise, strain difference characteristics were then evaluated. Compared to the control subjects, both longitudinal and circumferential LSS showed different degrees of reduction in hypertensive group, which was more pronounced at peak exercise. The global longitudinal endocardium strain (GLSendo) at rest was 24.4% ± 1.5% in the control group versus 20.4% ± 2.3% in the hypertensive group, while the difference was more obvious at peak state (control vs. hypertensive group, 30.8% ± 2.8% and 22.8% ± 2.9%, respectively). In particular, endocardial strain under exercise can be used as a sensitive indicator where the LV contractile reserve (CR) function of the three layers are all impaired. TESE combined with LSS might increase diagnostic accuracy of myocardial performance in hypertension patients.

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Early predictors of left ventricular dysfunction in hypertensive patients: comparative cross-section study

Cited by 13 publications

References 30 publications

Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies

Myocardial strain in hypertension: a meta-analysis of two-dimensional speckle tracking echocardiographic studies

Assessment Of Left Ventricular Systolic Function By Speckle Tracking Echocardiography In Young Hypertensive Patients

Evaluation of left ventricular function by treadmill exercise stress echocardiography combined with layer‐specific strain technique in essential hypertension patients

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