Evaluation of functional indices of left ventricular wall layers using layer-specific strain analysis in normotensive and hypertensive patients

Abstract

Background: In systemic hypertension, left ventricular remodeling results in an increase in ventricular wall thickness due to augmented ventricular afterload. Most studies on myocardial function in hypertensives are performed using imaging techniques in which the evaluation of myocardial wall thickness is performed without separating the LV myocardial triple layers from the endocardium to the pericardium. The specific myocardial function of each layer or layer-specific in both segmental and global form can also be examined using left ventricular strain analysis. The purpose of the present study was to evaluate the functional indices of each layer of the left ventricular myocardium using layer-specific strain analysis and also to evaluate the relationship between ventricular structural remodeling with the functional changes of the ventricle in each layer of the myocardium in hypertensive and normotensive individuals. Methods: Eighty eight patients (46.6% were normotensive and 53.4% were hypertensive) underwent two-dimensional echocardiography and longitudinal and circumferential strain indices were analyzed in all three layers. All parameters evaluated in terms of diastolic dysfunction were compared between two groups. Results: In patients with diastolic dysfunction, GLS and GCS strains significantly decreased in epicardial and mid myocardial layers in hypertensive patients, but these changes did not revealed in those without diastolic dysfunction. Conclusion: Decreases in GLS and GCS indices of the ventricular wall in mid myocardium and epicardial layers are predictable in the context of hypertension, and these changes in strain are evident in patients with ventricular diastolic dysfunctio