Speckle-Tracking and Tissue-Doppler Stress Echocardiography in Arterial Hypertension: A Sensitive Tool for Detection of Subclinical LV Impairment

Abstract

Early diagnosis of cardiac alterations in hypertensive heart disease is still challenging. Since such patients might have depressed global LV systolic strain or strain rate when EF is still normal, speckle-tracking echocardiography (STE) and tissue-Doppler imaging (TDI) combined with stress echocardiography might improve early diagnosis of cardiac alterations. In this prospective study standard 2D Doppler echocardiography, STE, and TDI were performed at rest and during bicycle exercise in 92 consecutive patients—46 hypertensive subjects with normal ejection fraction and 46 healthy controls. STE and TDI were used to measure global peak systolic LV circumferential strain (CS), longitudinal strain (LS), and longitudinal strain rate (SR). Mean arterial blood pressure was significantly higher in hypertensive patients at rest (100.8 mmHg SD 13.5 mmHg; P = 0.002) and during physical exercise testing (124.2 mmHg SD 13.4 mmHg; P = 0.003). Hypertensive patients had significantly reduced values of systolic CS (P = 0.001), LS (P = 0.014), and SR (P < 0.001) at rest as well as during physical exercise—CS (P < 0.001), LS (P < 0.001), and SR (P < 0.001). Using STE and TDI, reduced LV systolic strain and strain rate consistent with early cardiac alterations can be detected in patients with arterial hypertension. These findings were evident at rest and markedly pronounced during exercise echocardiography.

Increased mean aliphatic lipid chain length in left ventricular hypertrophy secondary to arterial hypertension

“…This evidence suggests a diastolic dysfunction in hypertensive patients with LV remodeling and points out the limitations [45] of current techniques such as Doppler and 2D echocardiography in the evaluation of diastolic [46] and left atrial function. [47] New tools such as 2D speckle tracking echocardiography [48] should be useful for early detection of cardiac malfunction due to arterial hypertension. [48–50] …”

“…[47] New tools such as 2D speckle tracking echocardiography [48] should be useful for early detection of cardiac malfunction due to arterial hypertension. [48–50] …”

Left Ventricular Function and Physiological Performance in Female Ironman Athletes and Female Police Officers

“…2D-Echocardiography, Colour Doppler, PW-Doppler, and Tissue Doppler Imaging (TDI) were used (Hensel, Jenke, & Leischik, 2014;Lang et al, 2015;Nagueh et al, 2009).…”

Echocardiographic assessment of myocardial ischemia

“…It's postulated that it can also be used to evaluate the function of the ventricular fiber architecture (80,81) and to measure dynamic changes in the geometry and fibrous structure of the heart (82). Acute systolic and diastolic changes during angioplasty could potentially be evaluated using strain and strain rate measurements (83) as well as early changes in myocardial function in hypertensive patients could be detected (30). The first announcements about the use of strain-technology in CHD were published by Voigt et al (84,85).…”

“…Although it sounds quite provocative, this hypothesis is tenable. Cardiovascular magnetic resonance (CMR) (21) and computed tomography (cardio-CT) (22,23) are important tools for ischemic (24) heart disease, but the depth of modern echocardiography (13)(14)(15)(25)(26)(27)(28)(29)(30) and the technical possibilities of advanced echocardiography with the corresponding experience provides many of the answers we need. The use of echocardiography can differ between the USA and Europe.…”