Abstract
Background : Systolic hypertension causes LV hemodynamic changes ranging from
maladaptive hypertophy to heart failure. (TDI) and 2D strain provides an objective way to
quantify global and regional left ventricular (LV) systolic and diastolic function with improved
accuracy and greater reproducibility.
Objectives: The aim was to assess the systolic and diastolic changes in the myocardium
of hypertensive patients and its usefulness in early detection of subclinical dysfunction to
determine the parameter that most specifically can represent these abnormalities.
Methods: 95 normotensive volunteers (GP A), 45 hypertensive patients without LVH
(GP BI) and 47 hypertensive with LVH (GP BII) were examined by standard echocardiography,
TDI and speckle tracking.
Results: PWD indices were not significantly different among the 3 groups but TDI
indices showed statistically significant difference between three groups in E/Em global and
IVRT. In GP BII there was slight increase in IVCT, moderate decrease of Sm and significantly
increased IVRT and longer MPI. In the hypertension group, mean longitudinal strain was
significantly reduced compared with controls and the difference between the 2 subgroups of
hypertensive patients was also statistically significant and significant inverse associations
between left ventricular mass and global longitudinal systolic strain in hypertensive patients.
Conclusion: TDI and speckle tracking were able to detect subclinical heart disease in
hypertensive patients without LVH and to demonstrate that E/Em and IVRT can predict early
diastolic dysfunction more accurately than Em. IVRT is a more accurate index than MPI in
patients without LVH and GLPSS can determine early systolic dysfunction. |
