Association between Heart Rate and Global Left Ventricular Longitudinal Strain and Left Atrium Structural and Functional Changes in Hypertensive Patients with Normal Left Ventricular Ejection Fraction (A Speckle Tracking Study)

Abstract

Background and Aim: The structure and function of the left heart cavity have important prognostic value in heart diseases, and heart rate (HR) control is an important treatment goal. In this study, we investigated the effects of HR on left heart structure and function in hypertensive patients with normal left ventricular (LV) systolic function. Materials and Methods: This was a single-center, prospective, observational (case-control) study. A total of 153 patients were included in the study. Patients were divided into two groups according to their HR (70 beats/min and below and above 70 beats/min). LV and atrial strain analyses were performed during echocardiographic evaluation. Results: Patients with a resting HR of 70 beats/min or less were included in group 1 (64.2±4.5) and patients with a resting HR above 70 beats/min were included in group 2 (79.1±6.8). There is a significant difference between group 1 and group 2 in left atrial maximum volume (60.8±15.5 mL vs. 52.9±16.3 mL P = 0.007), left atrial minimum volume (28.8±9.5 vs. 22.6±7.9 P < 0.001), left atrial emptying fraction (52.8±8.5% vs. 56.1±8.5% P = 0.035), left atrial expansion index (1.19±0.44 vs. 1.36±0.47 P = 0.044), pLASRcd (-1.3±0.38 vs. -1.5±0.61 P = 0.031), and global longitudinal strain (-19.3±3 vs. -18.2±2.7 P = 0.07). In the multivariable regression analysis, beta-bloker [odds ratio (OR): 0.291, 95% confidence interval (CI) 0.105-0.810, P = 0.018], mean high diastolic blood pressure (OR: 1.054, 95% CI 1.009-1.101, P = 0.018), left atrial minimum volume (OR: 0.870, 95% Cl 0.809-0.938, P < 0.001), S’ (OR: 10.6, 95% CI 1.1-104, P = 0.041), left atrial expansion index (OR: 0.870, 95% CI 0.809-0.930, P < 0.033) were determined as independent predictors of high resting HR. Conclusion: HR control is an important goal in patients with hypertension who have preserved LV systolic function. Mortality and morbidity can also be improved by HR control.

Keywords

• heart rate
• hypertension
• strain
• preserved left ventricular systolic function