Evaluation of Left ventricular systolic function by Myocardial Deformation Imaging in Hypertensive patients with Preserved Left Ventricular Ejection Fraction

Abstract

Background and Aims: Hypertension being one of the commonest non communicable diseases is major risk factor leading to premature death.1 With development of, the left ventricular strain imaging technique by echocardiography the consequences of hypertension may be identified and intervene earlier. The aim of study was to show abnormalities in cardiac function in the form of left ventricular strain imaging in hypertensive patients with preserved Ejection fraction. Methods: This was a cross-sectional, comparative and observational study done in Shahid Gangalal National Heart Centre and National Academy of Medical Sciences, Bir Hospital Kathmandu which included hypertensive patients with baseline examination including a medical history, clinical examination and a standardized trans thoracic echocardiography and strain imaging examination and the findings were compared among age and sex frequency matched 82 healthy adults in 1 : 2 ratio. The independent paired t test was used for the comparative statistical analysis. Results: We enrolled 240 patients in this study, 158 were hypertensive (mean age 48.5 ±6.1 years with 50.6 % female) and 82 healthy control (mean age 45.62 ±6.3 years with 51.2% female). There was no significant difference in conventional echocardiographic parameters between two groups except for left ventricular mass index and relative wall thickness that was highest in hypertensive group (p value of <0.001). The hypertensive population has lower mean global longitudinal strain (GLS) value of -18.6% ± 2.06 SD compared to the healthy control population with mean of -19.5% ± 1.1 SD (p value of <0.001). Conclusion: Hypertensive patients with preserved left ventricular ejection fraction have subclinical left ventricular dysfunction revealed by GLS imaging technique.

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

“…LV end diastolic diameter (LVEDD) and volumes (LVEDV) were substantially greater in hypertensive group (p= 0.001), Also LA diameter (LAD), Aortic root diameter and LA volume index were substantially greater in hypertensive groups (p= 0.001, 0.001 and 0.001 respectively). This was in harmony with the study by Baral et al 15 . In this research, 240 patients were included, 158 of whom were hypertensive (average age 48.5±6.1 years, 50.6 percent female) and 82 of whom were healthy controls (average age 45.62±6.3 years, 51.2 percent female).…”

“…Additionally, regarding our findings Baral et al 15 only BMI was substantially greater in individuals with lower GLS than in those with normal GLS (P <0.003).…”

“…Also, in harmony with our findings Ayoub et al 14 reported that there By the Simpson approach, there was no substantial variation between the two groups in terms of EF (p>0.05). In individuals with systemic hypertension, GLS was substantially reduced (−20.75 ± 1.56 in the control group vs. −19.54 ± 2.43 in the hypertensive group) Also, the study by Baral et al 15 15 who reported that in the hypertension group, 54 of 158 patients (34.2%) exhibited subclinical LV systolic dysfunction (defined as GLS less than 18%), while only 1 of 82 controls (1.2%) had preclinical LV dysfunction. This result was comparable to that of research by Saghir et al 18 when compared to control participants, hypertensive individuals with LVH showed substantially lower systolic longitudinal strain and strain rate values.…”