International Journal of Biomedicine. 2021;11(4):403-409.
Originally published December 10, 2021
Background: Increased myocardial fibrosis in hypertension leads to abnormalities in left ventricular diastolic function. 3D-speckle-tracking imaging (3D-STI) is a primary imaging modality used to detect early changes in the left ventricle (LV). The aim of this study was to assess the left ventricular myocardial function in hypertensive patients using 3D-speckle tracking imaging (3D-STI).
Methods and Results: A case control, nonintervention, descriptive study was conducted in the Department of Ultrasound Diagnosis of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology (Wuhan, Hubei, China). The study subjects included 64 patients with hypertension (HT) and, as control group, 44 normotensives. HT patients were divided into HT-I group (SBP of 130-139 mmHg or DBP of 80-89 mmHg, and HT-II group (SBP >140 mmHg or DBP >90 mmHg). In this study, LV geometry and function were assessed using conventional 2D- and 3D-echocardiography in a total of 108 consecutive subjects. LV volumes, global and regional strains were measured using 3D-STI. LV ejection fraction (LVEF) was in normal range in three groups, but in general, it slightly decreased in HT-II patients, compared with control and HT-I groups (62.5±2.1%, 68.0±2.2%, and 67.5±1.3%, respectively, P=0.00). Global systolic strain demonstrated a significant decrease in GLS, GCS, and GRS in the HT-II group, compared with control and HT-I groups. All regional strain parameters (longitudinal, circumferential, and radial) significantly decreased in HT-II patients, compared with control and HT-I groups.
Conclusion: A significant deterioration of global LV systolic functions is found in hypertensive patients with well-preserved LVEF, especially in patients with hypertension stage II.
- Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006.
- Schwartzbard AZ, Newman JD, Weintraub HS, Baum SJ. The 2017 high blood pressure clinical practice guideline: The old and the new. Clin Cardiol. 2018 Mar;41(3):279-281. doi: 10.1002/clc.22905.
- Cuspidi C, Meani S, Valerio C, Fusi V, Sala C, Zanchetti A. Left ventricular hypertrophy and cardiovascular risk stratification: impact and cost-effectiveness of echocardiography in recently diagnosed essential hypertensives. J Hypertens. 2006 Aug;24(8):1671-7. doi: 10.1097/01.hjh.0000239305.01496.ca.
- Yip GW, Zhang Q, Xie JM, Liang YJ, Liu YM, Yan B, Lam YY, Yu CM. Resting global and regional left ventricular contractility in patients with heart failure and normal ejection fraction: insights from speckle-tracking echocardiography. Heart. 2011 Feb;97(4):287-94. doi: 10.1136/hrt.2010.205815. Epub 2010 Dec 30. Erratum in: Heart. 2011 Mar;97(6):516. Xie, Jun-Mei [corrected to Xie, Jun-Min].
- Lafitte S, Perlant M, Reant P, Serri K, Douard H, DeMaria A, Roudaut R. Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis. Eur J Echocardiogr. 2009 May;10(3):414-9. doi: 10.1093/ejechocard/jen299.
- Maffessanti F, Nesser HJ, Weinert L, Steringer-Mascherbauer R, Niel J, Gorissen W, Sugeng L, Lang RM, Mor-Avi V. Quantitative evaluation of regional left ventricular function using three-dimensional speckle tracking echocardiography in patients with and without heart disease. Am J Cardiol. 2009 Dec 15;104(12):1755-62. doi: 10.1016/j.amjcard.2009.07.060.
- Nesser HJ, Mor-Avi V, Gorissen W, Weinert L, Steringer-Mascherbauer R, Niel J, Sugeng L, Lang RM. Quantification of left ventricular volumes using three-dimensional echocardiographic speckle tracking: comparison with MRI. Eur Heart J. 2009 Jul;30(13):1565-73. doi: 10.1093/eurheartj/ehp187.
- Whelton PK, Carey RM. The 2017 Clinical Practice Guideline for High Blood Pressure. JAMA. 2017 Dec 5;318(21):2073-2074. doi: 10.1001/jama.2017.18209.
- Saltijeral A, Perez de Isla L, Veras K, Fernandez Mde J, Gorissen W, Rementeria J, Almeria C, Rodrigo JL, Fernandez-Golfin C, Marcos-Alberca P, Macaya C, Zamorano J. Myocardial strain characterization in different left ventricular adaptative responses to high blood pressure: a study based on 3D-wall motion tracking analysis. Echocardiography. 2010 Nov;27(10):1238-46. doi: 10.1111/j.1540-8175.2010.01234.x.
- Liu HY, Deng YB, Liu K, Li Y, Tang QY, Wei X, Chang S, Lu X. Left ventricular systolic strain of the cardiac allograft evaluated with three-dimensional speckle tracking echocardiography. J Huazhong Univ Sci Technolog Med Sci. 2013 Oct;33(5):765-769. doi: 10.1007/s11596-013-1194-8.
- Zhang L, Gao J, Xie M, Yin P, Liu W, Li Y, Klas B, Sun J, Balluz R, Ge S. Left ventricular three-dimensional global systolic strain by real-time three-dimensional speckle-tracking in children: feasibility, reproducibility, maturational changes, and normal ranges. J Am Soc Echocardiogr. 2013 Aug;26(8):853-9. doi: 10.1016/j.echo.2013.05.002.
- Monte IP, Mangiafico S, Buccheri S, Arcidiacono AA, Lavanco V, Privitera F, Leggio S, Deste W, Tamburino C. Early changes of left ventricular geometry and deformational analysis in obese subjects without cardiovascular risk factors: a three-dimensional and speckle tracking echocardiographic study. Int J Cardiovasc Imaging. 2014 Aug;30(6):1037-47. doi: 10.1007/s10554-014-0429-5.
- Rosei EA, de Simone G, Mureddu G, Trimarco B, Verdecchia P, Volpe M, et al. Arterial hypertension and cardiac damage: diagnostic and therapeutic guidelines. High Blood Pressure & Cardiovascular Prevention; Auckland. 2008 July:15(3):141-70. doi: 10.2165/0151642-200815030-00008
- Sadler DB, Aurigemma GP, Williams DW, Reda DJ, Materson BJ, Gottdiener JS. Systolic function in hypertensive men with concentric remodeling. Hypertension. 1997 Oct;30(4):777-81. doi: 10.1161/01.hyp.30.4.777.
- Ikonomidis I, Tzortzis S, Triantafyllidi H, Parissis J, Papadopoulos C, Venetsanou K, Trivilou P, Paraskevaidis I, Lekakis J. Association of impaired left ventricular twisting-untwisting with vascular dysfunction, neurohumoral activation and impaired exercise capacity in hypertensive heart disease. Eur J Heart Fail. 2015 Dec;17(12):1240-51. doi: 10.1002/ejhf.403.
- Galderisi M, Esposito R, Schiano-Lomoriello V, Santoro A, Ippolito R, Schiattarella P, Strazzullo P, de Simone G. Correlates of global area strain in native hypertensive patients: a three-dimensional speckle-tracking echocardiography study. Eur Heart J Cardiovasc Imaging. 2012 Sep;13(9):730-8. doi: 10.1093/ehjci/jes026.
- Yao H, Li J, Lin J, Huang B, Huang H. [Assessment of global left ventricular function in hypertensive patients with normal ventricular geometry using global area strain]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2013 Apr;30(2):306-11. [Article in Chinese].
- Haque T, Siddique R, Kabiruzzaman M, Khan AM, Choudhury S, Malik F. A11256 Assessment of Subclinical Systolic Dysfunction in Hypertensive Patients with Preserved Left Ventricular Ejection Fraction Using Three-Dimensional Speckle Tracking Echocardiography. Journal of Hypertension. October 2018;36: e174. doi: 10.1097/01.hjh.0000548707. 42035.ee
- El-Noamany MF, Dawood AAE, Hamed WAI, Amer NE. Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels. Cardiology and Cardiovascular Research. January 2020;4(3):131. doi: 10.11648 /j.cc r. 202 00403.19
- Hamed WAI, Kamal AM, Noamany MF, Soliman MA, Ra’ouf MMA. Evaluation of left ventricular performance in hypertensive patients by speckle tracking echocardiography: Correlation with brain natriuretic peptide. The Egyptian Heart Journal. 2014;66(4):299–308. doi: 10.1016/j.ehj.2014.08.002
- Lai YH, Lo CI, Wu YJ, Hung CL, Yeh HI. Cardiac Remodeling, Adaptations and Associated Myocardial Mechanics in Hypertensive Heart Diseases. Acta Cardiol Sin. 2013 Jan;29(1):64-70.
Received August 9, 2021.
Accepted August 25, 2021.
©2021 International Medical Research and Development Corporation.