Abstract

Background: We tested the hypothesis that global strain rate imaging can quantify and stratify the severity of left ventricular (LV) relaxation abnormality in patients with left ventricular hypertrophy (LVH) ranged from normal to reduced LV systolic function independently from longitudinal (L), circumferential (C), and radial axes (R). Methods: Fifty-seven patients with hypertensive LVH and thirty age matched controls (Control, EF 65 ± 5 %) had echo-study with speckle tracking strain and strain rate imaging from (L), (C), and (R). LVH were divided into two groups; normal EF (LVH-NEF) defined as EF ≥ 55% (n = 35, EF 64 = 5 %), and systolic dysfunction (LVH-SD) defined as EF < 55% (n = 22, EF 48 ± 8 %). Global peak systolic strain (PSS) and peak relaxation rate (PRR) were used as indices of global LV contraction and relaxation, respectively (Vivid 7 and EchoPAC, GE Electronic). Results: PSS was maintained in LVH-NEF but reduced in LVH-SD from all three perpendicular axes. PRR (L) was impaired in LVH-NEF and was further decreased in LVH-SD (0.95 ± 0.33* and 0.58 ± 0.24* † 1/s, *p <0.05 vs. Control and † p <0.05 vs. LVH-NEF, respectively)compared to Control (1.14 ± 0.30 1/s). PRR (C) was maintained in LVH-NEF but reduced in LVH-SD (1.24 ± 0.50 and 0.73 ± 0.36 1/s*, p <0.05 vs. Control) compared to Control (1.30 ± 0.48 1/s). PRR (R) was impaired in both LVH-NEF and LVH-SD in the same degrees (-1.53 ± 0.60* and -1.27 ± 0.64* 1/s, p <0.05 vs. Control: -2.08 ± 0.84 1/s). Conclusion: Speckle tracking strain rate imaging quantified and stratified the severity of LV relaxation abnormality in patients with LVH ranged from normal to reduced LV systolic function independently from all three perpendicular ventricular axes.

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