P3837Both left atrial and left ventricular multilayer longitudinal strain are impaired in early stages of arterial hypertension in postmenopausal women

Abstract

Abstract Background Left ventricular (LV) hypertrophy and left atrial (LA) dilation are powerful prognostic predictors in arterial hypertension (AH). However, their use is limited in the early stages of hypertensive heart disease. LV and LA global longitudinal strain (GLS) are promising diagnostic markers for identification of early myocardial dysfunction. The purpose of the study was to evaluate the longitudinal deformation of left heart chambers in hypertensive postmenopausal women prior to LV hypertrophy and LA dilation development. Methods The study enrolled 100 postmenopausal hypertensive women (mean age 57.5±4.1 years), divided into 2 groups, and 26 healthy females (control group). The 1st group included 32 women with structurally normal hearts and the 2nd group consisted of 68 females with LV hypertrophy (LV mass index >95 g/m2) and LA dilation (LA volume index >34 ml/m2). LV multilayer GLS was calculated with 2D speckle tracking echocardiography. LA GLS was computed by averaging 12 segmental values with both P- and R- wave ECG-triggering. Strain was measured in contractile and reservoir phase, calculating GLS as sum of these values with P-wave variant, and as maximal peak of curves with R-wave method. The data are presented as median and interquartile range. Results The LV GLS was significantly lower in hypertensive women with structurally normal hearts in all myocardial layers compared to healthy females (table). The LA longitudinal strain was reduced due to the deterioration of reservoir phase. The reduction of LA GLS in hypertensive women with structurally normal hearts was detected using R-wave triggering method only (opposite to P-wave method). Left heart chambers longitudinal strain Parameter Control group 1st group 2nd group p LV GLS endo, % −23.75 (−20.3; −25.15) −21.25 (−19.6; −22.35)* −21.2 (−20.14; −22.9)* 0.047 LV GLS mid, % −21.4 (−18.5; −22.6) −19.1 (−17.8; −20.45)* −19.1 (−17.95; −20.15)* 0.03 LV GLS epi, % −18.7 (−16.75; −20.2) −16.95 (−15.95; −18.5)* −17.1 (−15.96; −18.05)* 0.03 P-wave triggering LA LS in contractile phase, % −15.75 (−13.41; −16.37) −15.38 (−13.69; −17.77) −14.99 (−12.97; −16.89) 0.47 LA LS in reservoir phase, % 17.19 (15.4; 20.2) 13.19 (8.8; 18.03)* 13.54 (10.45; 16.19)* 0.0004 LA GLS, % 31.01 (25.11; 35.59) 28.37 (24.29; 32.5) 26.73 (23.21; 30.54)* 0.02 R-wave triggering LA GLS, % 38.3 (34.54; 43.43) 33.63 (30.11; 36.28)* 30.77 (26.23; 36.11)* 0.0002 *p<0.05 compared to control group. Conclusions LV multilayer and LA GLS are reduced prior to LV hypertrophy and LA dilation development in hypertensive postmenopausal women and may be considered as early signs of myocardial dysfunction.