Left Ventricular Strain in Patients with Hypertensive Heart Disease and Normal Ejection Fraction Assessed by Speckle Tracking Echocardiography

Hamideh Khesali; Sara Barzegar; Raheleh Kaviani; Amir Askarinejad; Hamed Bazrafshan Drissi; Mohamad Ali Ghaznavi

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Left Ventricular Strain in Patients with Hypertensive Heart Disease and Normal Ejection Fraction Assessed by Speckle Tracking Echocardiography

Author(s):

Hamideh Khesali

¹,

Sara Barzegar

^1,*,

Raheleh Kaviani

¹,

Amir Askarinejad

²,

Hamed Bazrafshan Drissi

³,

Mohamad Ali Ghaznavi

¹

1Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran

2Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

3Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran

International Cardiovascular Research Journal:Vol. 16, issue 4; e130653

Published online:Dec 31, 2022

Article type:Research Article

Received:Aug 06, 2022

Accepted:Dec 10, 2022

How to Cite:Khesali H, Barzegar S, Kaviani R, Askarinejad A, Bazrafshan Drissi H, et al. Left Ventricular Strain in Patients with Hypertensive Heart Disease and Normal Ejection Fraction Assessed by Speckle Tracking Echocardiography. Int Cardiovasc Res J. 2022;16(4):e130653. doi:

Abstract

Background: Hypertension is a major risk factor for cardiovascular diseases and is associated with increased all-cause and cardiovascular mortality. Cardiac changes such as impaired left ventricular (LV) function, left ventricular hypertrophy (LVH), and heart failure are consequences of chronic exposure to elevated blood pressure. Speckle tracking echocardiography (STE) is a sensitive method for detecting early regional and global myocardial dysfunction missed in asymptomatic patients with cardiovascular disease by conventional modalities.

Objectives: This study aimed to assess the ability of 2D-STE in assessing regional and global LV strain to diagnose subclinical LV dysfunction in patients with systemic hypertension and preserved ejection fraction.

Methods: This prospective observational study included 80 hypertensive patients and 30 healthy controls. In the hypertensive group, at least six months had passed from diagnosis of hypertension according to AHA guidelines. 2D echocardiographic LV images were acquired in apical 4, 2, and 3-chamber and parasternal short axis views. Left ventricular global longitudinal strain (LVGLS) and circumferential strain (LVGCS) were quantified in all segments using a Philips Affiniti 70 device. Differences between hypertensive patients and controls were analyzed using the independent t-test. A P-value less than 0.05 was considered statistically significant.

Results: In comparison, LVGLS and LVGCS were significantly (P < 0.001) lower among the hypertensive group (GLS: -17.43 ± 1.71, GCS: -23.76 ± 3.35) than the control group (GLS: -20.18 ± 1.11, GCS: -27.46 ± 4.33). LVGLS was significantly (P < 0.001) lower in uncontrolled hypertension (-16.91 ± 1.70) vs. controlled hypertension (-17.96 ± 1.57). Similarly, LVGLS was significantly (P < 0.001) lower among the cases with LVH on 2D echocardiography (16.23 ± 1.69) compared to those without LVH (17.96 ± 1.6). In the hypertensive group, LVGLS was significantly lower in males (-16.84 ± 1.42) than in females (-18.02 ± 1.78; P < 0.05).

Conclusion: This study demonstrates the potential benefits of using STE as a non-invasive imaging technique in assessing cardiac remodeling and providing a further risk assessment of hypertensive patients.

Keywords

Hypertrophy

Hypertension

myocardial contraction

Heart Failure

speckle-tracking echocardiography

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References

1.
The references are available in pdf.

Investigation of the Possible Risk Factors Associated with Subclinical Left Ventricular Dysfunction Assessed by 2D Speckle Tracking Echocardiography in Patients with Type 2 Diabetes Mellitus and Normal Ejection Fraction

Mehdi Pishgahi,

Fariba Bayat,

Rama Bozorgmehr,

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Hamid Rafiei Sadr,

Seyedeh Maryam Motahari

,et al.

Pishgahi M, Bayat F, Bozorgmehr R, Ghane Fard S, Rafiei Sadr H, et al. Investigation of the Possible Risk Factors Associated with Subclinical Left Ventricular Dysfunction Assessed by 2D Speckle Tracking Echocardiography in Patients with Type 2 Diabetes Mellitus and Normal Ejection Fraction. Int Cardiovasc Res J. 2023;17(2):e138792. doi:

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Pazoki M, Kianmehr N, Hajahmadi M, Joghataie P, Amirinasab Sarabi N. Early Detection of Subclinical Left Ventricular Dysfunction in Patients with Systemic Lupus Erythematosus: A Case-Control Study. Jundishapur J Chronic Dis Care. 2022;11(2):e121401. doi: https://doi.org/10.5812/jjcdc.121401

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Elham Rajaei,

Nasim Pournaghshband Isfahani,

Nehzat Akiash,

Mohammad Mohammadi,

Karim Mowla

Rajaei E, Pournaghshband Isfahani N, Akiash N, Mohammadi M, Mowla K. Evaluation of the Left Ventricular Function in Patients with Scleroderma with Normal Pulmonary Artery Pressure Using Myocardial Strain Analysis: A Cross-Sectional Study. Int Cardiovasc Res J. 2022;16(4):e130889. doi:

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Rozita Jalalian,

Babak Bagheri,

Abbas Alipour,

Mohsen Sinaeii,

Mahsa Mohammadi,

Mohammadreza Iranian

Jalalian R, Bagheri B, Alipour A, Sinaeii M, Mohammadi M, et al. The Rule of Speckle Tracking Echocardiography Indicators, Including Post Systolic Shortening Index, in Predicting Left Ventricular Ejection Fraction Improvement and Detection of Viable Myocardium in Patients With ST-segment Elevation Myocardial Infarction who Undergo Late Percutaneous Coronary Intervention. Int J Cardiovasc Pract. 2025;10(1):e160173. doi: https://doi.org/10.5812/intjcardiovascpract-160173

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Lida Peivandi,

Vahid Reza Dabbagh Kakhki

Peivandi L, Dabbagh Kakhki VR. Assessment of Correlation of Left Ventricular Diastolic Functional Indices Between Gated Myocardial Perfusion SPECT and Echocardiography. I J Radiol. 2017;14(Special Issue):e48002. doi: https://doi.org/10.5812/iranjradiol.48002

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Author(s):

Hamideh Khesali:[PubMed][Scholar]
Sara Barzegar:[PubMed][Scholar]
Raheleh Kaviani:[PubMed][Scholar]
Amir Askarinejad:[PubMed][Scholar]
Hamed Bazrafshan Drissi:[PubMed][Scholar]
Mohamad Ali Ghaznavi:[PubMed][Scholar]

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Left Ventricular Strain in Patients with Hypertensive Heart Disease and Normal Ejection Fraction Assessed by Speckle Tracking Echocardiography

Abstract

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