Role of Two- Dimensional Speckle Tracking Strain versus Conventional Echocardiography in the Assessments of Left Ventricular Systolic Function in Middle-aged Hypertensive Patients.

Abstract

Background: Systemic hypertension is a major risk factor for cardiovascular accidents. The early management of its complication on the heart plays an important role in the outcome of the disease. Hypertension is associated with changes in several aspects of left ventricular structure, function, systolic strains. Various echocardiographic techniques are used to evaluate left ventricular function in hypertensive patients. Objectives: Evaluate the effectiveness of speckle tracking global left ventricular strain percentage (GLVS%) in the assessments of left ventricular systolic function in comparison to conventional echocardiography in middle-aged hypertensive patients. Patients and Methods: The study conducted at the Department of Echocardiography and Catheterization / Baghdad Teaching Hospital – Medical city, Baghdad, Iraq. One hundred and four primary hypertensive patients with a mean age of (48.6± 6 years) classified into; group I that involved 76 patients with reversed E/A ratio on PW Doppler with reversed PW tissue Doppler study and group II with 28 patients having normal E/A ratio on PW Doppler and reversed E prime/A prime on PW tissue Doppler study. The control (group III) included one hundred and four sex age-matched healthy individuals. A detailed history with the recommended investigation and blood pressure measurements was performed for all participant. Additionally, echocardiography examination implemented using standard methods, considering Left ventricle (LV) internal dimension, LV EF%, LV diastolic function using PW Doppler and lateral mitral annular tissue Doppler, S prime, Mitral annular plane systolic excursion (MAPSE) and global LV speckle tracking strain%. Results: All the participants had normal EF%, MAPSE, and S prime while there are significantly decreased GLVS% in the diseased groups (P < 0.005) being less in group II (-14 ± 1%) than in Group I (-16 ± 1%). In addition to a significant negative linear correlation between GLVS% with the pulse pressure, IVST, E/A and E/ E prime Conclusions: Speckle tracking global left ventricular strain percentage (GLVS%) could detect early an impaired systolic function in hypertensive patients despite preserved LV systolic function measured by the conventional echo methods.

Keywords

• Systemic hypertension; Tissue Doppler Imaging; Speckle tracking echocardiograph