The Impact of Uncontrolled Hypertension on the Longitudinal Systolic Function of the Left Ventricle

Abstract

Background: The assessment of the longitudinal component of left ventricular (LV) function is of major clinical importance for the early detection of LV contractile impairment. The aim of this study was to determine the impact of uncontrolled hypertension, on LV longitudinal systolic performance. Methods: The study population included 400 hypertensive patients: 271 patients with uncontrolled blood pressure (BP) and 112 without controlled BP, all patients underwent a complete ultrasound evaluation with calculation of the LV mass, evaluation of diastolic function as well as longitudinal systolic function. Results: Conventional echo demonstrated that uncontrolled patients had increased LV mass (P 0.007), LA (left auricular) dimension (P 0.004), left ventricular wall thickness and impairment of diastolic function (E/E’6 ± 2.1 vs 7.4 ±3.0 P=0.001) while no affection of systolic function could be detected. By deformation imaging, there was a reduction in longitudinal strain (apical 4 view -16.2 ±2.9 vs -18.2± 2.6 P 0.02, apical 3 view -17.3 ± 3.3 vs. -18.9 ± 4.1 P 0.01). Similarly systolic strain rate (SRsys) and early diastolic SR (SRe) reduced significantly in longitudinal direction. Conclusion: Although EF was not different between uncontrolled patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking were lower in the uncontrolled group.

The relationship of superoxide dismutase and malondialdehyde levels with left ventricular geometry and function in patients with primary hypertension

“…This may be because myocardial interstitial fibrous tissue hyperplasia and rearrangement of myocardial fibers were more obvious, leading to a more significant decline in myocardial strain function 11 . The research of Bendiab 12 and Kouzu et al 13 also confirmed the above views.…”

Impact of Diabetes on Cardiac Function in Patients with High Blood Pressure

“…Indeed, weight loss has been reported to improve cardiac structure and function of patients with overweight [ 23 ]. Accordingly, effective and optimal treatment of HBP should be obtained in very high risk hypertensive patients such as those with T2DM [ 24 ]. In addition, antihypertensive drugs such as angiotensin-converting enzyme inhibitors, as observed in the present study, may have direct protective effects, and their use may contribute to reduced vascular complications in patients with HBP and concomitant T2DM [ 25 ].…”