Myocardial Stratified Strain Technique on Left Ventricular Systolic Function in Essential Hypertension

Abstract

Objective: To study and analyze the clinical application value of myocardial stratification strain technique on the functional changes of the left ventricular triple layer myocardium in patients with essential hypertension. Methods: Thirty patients with essential hypertension, 30 hypertensive patients with left ventricular hypertrophy diagnosed by electrocardiography or by ultrasound, 30 hypertensive patients without left ventricular hypertrophy and 30 patients with normal blood pressure were selected as the control group. Two-dimensional dynamic images of the basal, intermediate and apical segments of the left ventricle were acquired in short-axis views over three consecutive cardiac cycles using a Philips ultrasound instrument. The CS of each layer of myocardium in the basal, intermediate and apical segments of the left ventricle was determined using the circumferential stratified strain technique and the strain values were compared between the three groups. Results: 1. The absolute value of CS in each layer of myocardium from the endocardium to the epicardium decreased layer by layer in the control, NLVH and LVH groups. 2. The absolute values of CS in the middle and basal segments of each layer were lower in the control, NLVH and LVH groups than in the apical segments. 3. Compared with the control group, the absolute values of CS in all layers of the subendocardial, basal and intermediate segments of the apical segment were slightly reduced in the NLVH group without statistical significance (P>0.05), and the absolute values of CS in the mid and subepicardial segments of the apical segment were lower than those of the control group, but the differences were not statistically significant (P<0.05); the absolute values of CS in the apical, basal and intermediate segments were reduced in the LVH group with statistical differences (P<0.05). 4. Compared with the NLVH group, the LVH group showed a significant reduction in the absolute CS values of the layers of the apical segment, the middle and outer layers of the intermediate segment and the middle and outer layers of the basal segment, and a reduction in the absolute CS values of the inner layers of the basal and intermediate segments, but the difference was not statistically significant (P>0.05). Conclusion: The stratified strain technique can quantitatively evaluate the local and global systolic function of the left ventricular myocardium in a stratified manner. It can evaluate the altered function of the left ventricular myocardium in all layers of hypertensive patients with altered left ventricular configuration, and is expected to provide a new method for quantitative clinical evaluation of abnormal left ventricular systolic function.