Assessment of the left ventricular performance in hypertensive patients with normal coronary angiography and ejection fraction: Insight by two-dimensional speckle tracking echocardiography


Aim: To evaluate the validity of the longitudinal speckle tracking echocardiography (STE) in the detection of early changes in the performance of the left ventricle for hypertensive patients with normal ejection fraction (EF) and coronary angiography. Patients and Methods: A case-control study enrolled 50 patients and a randomly collected control group of 30, who consulted Ibn-Albitar Cardiac Center from November 2016 to the first September 2017. The patients had hypertension while the control did not. Both had normal coronary angiography, assessed by conventional echocardiography, two-dimensional STE, and anthropometric measures. Results: The mean age for the patients or cases was 52.48 ± 4.292 years, and their mean body mass index (BMI) was 30.10 ± 1.854 kg/m2. They had been diagnosed with hypertension for a mean duration of 8.14 ± 3.326 years. All were on treatment; the mean left ventricular (LV) mass was 108.96 ± 19.469 (g/m2) while the mean global longitudinal strain (GLS) was −16.720 ± 3.191. There was an approximately equal number of males and females among the cases: 24 (48.0%) and 26 (52.0%), respectively. Twenty-seven (54.0%) had LV hypertrophy (LVH), and only 4 (8.0%) cases had diastolic dysfunction with GLS −12. The mean age of the controls was 55 ± 4.792 years, and their BMI was 30.77 ± 2.063 kg/m2. They had a mean LV mass of 92.50 ± 10.058 (g/m2) and their GLS was slightly lower (more negative) than the cases, at −17.517 ± 2.222. Thirteen controls were males (43.3%) while 17 (56.7%) were females. Only 2 (6.7%) had diastolic dysfunction with GLS −14. GLS was significantly higher (less negative) in the cases with LVH compared to the controls: 15.278% compared to −17.517% respectively, with a mean difference of −2.238%. There was no statistically significant difference between controls and cases without LVH. Conclusions: The use of STE is beneficial in the detection of subtle changes in the LV of hypertensive patients with normal coronary angiography and normal EF.