Regional Left Ventricular Distribution Of Abnormal Segmental Relaxation Evaluated By Strain Echocardiography In Hypertensive Patients With Normal Global Diastolic Function Abstract

Aims Diastolic dysfunction(DD) identifies patients with increased cardiovascular risk.The aim of this study was to investigate the regional distribution of abnormal segmental relaxation in hypertensives with normal global DDMethods and results We evaluated 105 individuals, consisting of 70 hypertensives and35 middle-aged volunteers as a control. None had DD based on global indices(deceleration time, isovolumic relaxation time, and E/A). Segmental early and late diastolic Doppler-derived strain rates(SRs) were recorded from 18 segments in the longitudinal axis. Mean relaxation of the basal, mid, and apical regions was also calculated. Non-hypertensive, middle-aged individuals had evidence of segmental DD that was mostly distributed at the basal parts of the heart, and in particular at the septal wall. Hypertensive patients had a lower mean relaxation based on SRE and SRE/A at the basal, mid, and apical regions, with the basal parts appearing more compromised and with higher segmental DD compared with controls. Segmental DD in that group was more extensive towards the mid and even apical regions, with the septal and basal inferior walls being the most heavily affected areas. The lateral wall and apical regions are more resistant to diastolic abnormalities in both groups.Conclusion strain echocardiography has an incremental value over global indices of DD for early detection of diastolic abnormalities.