A11256 Assessment of Subclinical Systolic Dysfunction in Hypertensive Patients With Preserved Left Ventricular Ejection Fraction Using Three Dimensional Speckle Tracking Echocardiography

Abstract

Objectives: To assess three-dimensional speckle tracking echocardiography (RT3DSTE) derived strain parameters for early detection of left ventricular (LV) systolic dysfunction in hypertensive patients with preserved LV ejection fraction (LVEF). Methods: Hypertensive patients without sign and symptoms of heart failure visiting outpatient department were recruited as cases and controls were normotensive patients and healthy volunteers. All subjects underwent 2D echocardiography, tissue Doppler imaging (TDI) & RT3DSTE. Cases were further divided into two groups based on presence or absence of LV hypertrophy (LVH) by 2D echo-cardiography. Strain parameters were compared among the three groups. Results: Thirty five healthy control (group 1), 35 hypertensive patients without concentric LVH (group 2) and 35 hypertensive patients with concentric LVH (group 3) were recruited. All subjects had LVEF > 50%. LV mass index (LVMI) & relative wall thickness (RWT) were significantly higher (p < 0.001) in hypertensive patients. There was no difference of mean LVEF among the groups. The systolic annular velocity by TDI was significantly reduced (p < 0.001) in group 2 and in group 3. The global left ventricular longitudinal systolic strain, radial strain & area strain by RT3DSTE were significantly reduced (p < 0.001) in both groups of hypertensive patients compared to control group, The global longitudinal strain showed significant correlation with LVMI (r = 0.647; p < 0.01) and RWT (r = 0.581; p < 0.001). Conclusion: Lower global LV systolic strain parameters detected by RT3DSTE in hypertensive patients provided a new insight for early detection of subclinical global systolic dysfunction in hypertensive patients with preserved LVEF.