Evaluation Of Left Ventricular Systolic Function In Patients With H-type Hypertension By Two Dimensional Layer-specific Speckle Tracking Imaging

Objective:The aim of this study was to evaluate left ventricular(LV)longitudinal and circumferential layer-specific myocardial strain in and radial strain of patients with H-type hypertension by 2-D speckle tracking echocardiography(2-D-STE).Methods:Thirty-five patients with H-type hypertension and 31 with non-H-type hypertensi on were enrolled in this study,with 37 healthy volunteers as the control group.Al l patients and controls underwent echocardiography.The left ventricular long-axis a nd stort-axis views were measured by Echo PAC 201 workstation to analyze glob al longitudinal peak systolic strain(GLS)and Global circumferential strain(GCS)in epicardial,mid-myocardial and endo-cardial layer(GLSendo,GLSmid,GLSepi,GCSendo,GCSmid,GLSepi,)and Global Radial strain(RS)of LV.Results:1.Left ventricular mass index(LVMI),relative ventricular wall thickness(RWT)and E/E’ of hypertension groups were significantly higher than the control group(P<0.05).2.Gradient feature of three-layer GLS and GCS across left ventricular wall was showed among three groups,the measured value in descending order were subendocardialmyocardial layer,mid-myocardial myocardial layer and subepicardial myocardial layer.The levels of GSC in the basal and middle segments were lower than those in the apical segment whille SR were higher than those in the apical segment.3.Compared with the control group,2CH-GLS,4CH-GLS,APLAX-GLS and the mean global longitudinal strain of LV(GLS-Avg)in full-layer myocardial of H-type hypertension group were reduced(P<0.05).GLS-Avg of endo-myocardium(GLS-Avgendo),4CH-GLS and APLAX-GLSendo of non-H-type hypertension patients were decreased(P<0.05).Compared with non-H-type hypertension group,2CH-GLS in three-layer myocardial of H-type hypertension patients was decreased(P<0.05).4.In the hypertensive group,the GRS in middle segments parameters decreased compared with those in the control group.5.In the H-type hypertension group,GCS was significantly decreased in all layer except basal segment while the non H-type hypertension group GCS only decreased in the epicardium and the middle myocardium of apical segments.Conclusion:Both H-type hypertension and non-H-type hypertension can result in the reduction of cardiac systolic function,especially H-type hypertension,which may indicate that HHcy aggravates myocardial damage and promotes the development of left ventricular hypertrophy.Layer-specific strain is a promising approach to evaluate the left ventricular global and regional myocardial systolic function in essential hypertension patients with HHcy and has a value of potential application in clinical practice.