Assessment of Left Ventricle Myocardial Function in Hypertensive Patients Using Three-Dimensional Speckle-Tracking Echocardiography (3D-STE)

Background: Increased myocardial fibrosis in hypertension leads to abnormalities in left ventricular diastolic function. 3D-speckle-tracking imaging (3D-STI) is a primary imaging modality used to detect early changes in the left ventricle (LV). The aim of this study was to assess the left ventricular myocardial function in hypertensive patients using 3D-speckle tracking imaging (3D-STI). Methods and Results: A case control, nonintervention, descriptive study was conducted in the Department of Ultrasound Diagnosis of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology (Wuhan, Hubei, China). The study subjects included 64 patients with hypertension (HT) and, as control group, 44 normotensives. HT patients were divided into HT-I group (SBP of 130-139 mmHg or DBP of 80-89 mmHg, and HT-II group (SBP >140 mmHg or DBP >90 mmHg). In this study, LV geometry and function were assessed using conventional 2D- and 3D-echocardiography in a total of 108 consecutive subjects. LV volumes, global and regional strains were measured using 3D-STI. LV ejection fraction (LVEF) was in normal range in three groups, but in general, it slightly decreased in HT-II patients, compared with control and HT-I groups (62.5±2.1%, 68.0±2.2%, and 67.5±1.3%, respectively, P=0.00). Global systolic strain demonstrated a significant decrease in GLS, GCS, and GRS in the HT-II group, compared with control and HT-I groups. All regional strain parameters (longitudinal, circumferential, and radial) significantly decreased in HT-II patients, compared with control and HT-I groups. Conclusion: A significant deterioration of global LV systolic functions is found in hypertensive patients with well-preserved LVEF, especially in patients with hypertension stage II.