Left ventricular dyssynchrony in hypertensive patients with normal systolic function: tissue synchronization imaging study

Abstract

ObjectiveThe objective of our study was to assess left ventricular (LV) dyssynchrony in hypertensive patients with normal systolic function using tissue synchronization imaging (TSI).BackgroundLV systolic and diastolic dyssynchrony are not uncommon in patients with hypertension. Dyssynchrony is associated with increasing incidence of heart failure, cardiovascular morbidity, and mortality.Patients and methodsA total of 71 individuals were enrolled in this study. They were divided into two groups.Group A included 51 hypertensive patients with good LV systolic function (ejection fraction≥ 50%) and narrow QRS on the ECG (<120 ms). We excluded individuals with any of the following: acute coronary syndrome, diabetes mellitus, atrial fibrillation, significant valvular heart disease, chronic renal failure, pulmonary hypertension, or myocardial or pericardial disease.Group B included 20 age-matched and sex-matched healthy volunteers and represented the control group.All participants underwent standard two-dimensional echocardiography and TSI.ResultsThe hypertensive group had significantly higher septal wall and posterior wall thickness than the control group. In addition, the LV mass was significantly higher in hypertensive patients than in controls (P < 0.05). The delay between the septal and lateral walls was significantly higher in hypertensive patients than in controls (67.882 ± 53.536 in HTN vs. 44.400 ± 39.495 in controls) (P < 0.05). The severity of dyssynchrony is significantly related to the LV mass, septal wall thickness, posterior wall thickness, and left ventricular end-diastolic dimension.ConclusionPatients with systemic hypertension and normal systolic function may demonstrate LV dyssynchrony by TSI. The severity of dyssynchrony is significantly related to LV mass, septal wall thickness, posterior wall thickness, and left ventricular end-diastolic dimension. Systolic dyssynchrony may identify hypertensive patients at risk for the development of congestive heart failure, and who may benefit from more intensive hypertension control at an earlier stage in their disease process.