Early Detection of Left Ventricular Subclinical Systolic Dysfunction in Hypertensive Patients: Speckle Tracking at Rest and after Dobutamine Stress Echocardiography Study

Abstract

Abstract Background: Hypertension is one of the major cardiovascular risk factor that may result in heart failure. Two-D transthoracic echocardiography (2-D TTE) recognizes reduction in left ventricular systolic function in late stages of the disease course, so early detection is of paramount importance. Objective: Our study intended to evaluate feasibility of speckle-tracking echocardiography (STE) to provide additional perceptions for early detection of hypertension induced left ventricular systolic dysfunction. Patient and Methods: We enrolled 40 hypertensive patients, 21 women (52.5%) their mean age was 54.55±9 years and 20 normotensive age and gender matched control individuals (10 women, their mean age was 53.20±12.06 years). All had normal left ventricular systolic function by 2-D TTE. STE performed at rest and low dose dobutamine. Patients with significant ischemic or valvular heart disease as well as atrial fibrillation, conduction abnormalities and diabetes excluded. Results: Systolic blood pressure was significantly higher in the hypertensive group patients (138.50±10.27 mmHg vs. 120.50±7.76 mmHg, respectively; P = <0.001). Compared to control group, hypertensive patients experienced significantly impaired global longitudinal STE at rest (-18.08±1.63% versus 20.50±1.52% respectively; P<0.001) and at low-dose dobutamine (-19.11±1.75% versus 22.61±1.88% respectively; P<0.008). Conclusion: Speckle tracking echocardiography increases the sensitivity in detecting subclinical cardiac involvement in early stages of hypertension compared to conventional 2-D echocardiography.