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


avatar Hamideh Khesali ORCID 1 , avatar Sara Barzegar ORCID 1 , * , avatar Raheleh Kaviani ORCID 1 , avatar Amir Askarinejad ORCID 2 , avatar Hamed Bazrafshan Drissi ORCID 3 , avatar Mohamad Ali Ghaznavi ORCID 1

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

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

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

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 Cardio Res J. 2022;In Press(In Press):e130653.


International Cardiovascular Research Journal: In Press (In Press); e130653
Published Online: December 31, 2022
Article Type: Research Article
Received: August 06, 2022
Revised: November 09, 2022
Accepted: December 10, 2022


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 noninvasive
imaging technique in assessing cardiac remodeling and providing a further risk
assessment of hypertensive patients.


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