Analysis of Factors Related to Early Left Ventricular Dysfunction in Hypertensive Patients with Preserved Ejection Fraction Using Speckle Tracking Echocardiography: A Cross-Sectional Study in Vietnam

Overview

Journal Diagnostics (Basel)

Date 2025 Jan 25

PMID 39857106

Authors

Hoang M Tran

Hung P Truong

Cuong C Tran

Tuan M Vo

Dung N Q Nguyen

Liem T Dao

Affiliations

Soon will be listed here.

Abstract

The purpose of this research was to assess the factors linked to early left ventricular (LV) dysfunction in hypertensive patients who have preserved ejection fraction (EF ≥ 50%) using speckle tracking echocardiography. : A cross-sectional study was carried out involving 579 outpatients recruited from City International Hospital in Ho Chi Minh City using a total sampling approach, where echocardiographic measurements and clinical data were gathered and analyzed. The prevalence of LV diastolic dysfunction among hypertensive individuals was found to be 45.25%, with 9.15% showing abnormal global longitudinal strain (GLS). Factors such as being over the age of 60, having diabetes, concentric LV hypertrophy, concentric LV remodeling, and LV diastolic dysfunction were identified as correlating with abnormal GLS ( < 0.05). In contrast, other cardiovascular risk factors, including smoking and dyslipidemia, did not significantly influence the GLS index ( > 0.05). Key factors including diabetes, diastolic dysfunction, concentric hypertrophy, and concentric remodeling of the LV are significant predictors of abnormal GLS. These results are important for the management of hypertensive patients aimed at enhancing cardiac function.

References

Alsharari R, Oxborough D, Lip G, Shantsila A . Myocardial Strain Imaging in Resistant Hypertension. Curr Hypertens Rep. 2021; 23(5):24. PMC: 8099817. DOI: 10.1007/s11906-021-01148-3. View

Mancia G, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G . 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013; 34(28):2159-219. DOI: 10.1093/eurheartj/eht151. View

Sitia S, Tomasoni L, Turiel M . Speckle tracking echocardiography: A new approach to myocardial function. World J Cardiol. 2010; 2(1):1-5. PMC: 2999040. DOI: 10.4330/wjc.v2.i1.1. View

Soufi Taleb Bendiab N, Meziane-Tani A, Ouabdesselam S, Methia N, Latreche S, Henaoui L . Factors associated with global longitudinal strain decline in hypertensive patients with normal left ventricular ejection fraction. Eur J Prev Cardiol. 2017; 24(14):1463-1472. DOI: 10.1177/2047487317721644. View

Hung C, Goncalves A, Shah A, Cheng S, Kitzman D, Solomon S . Age- and Sex-Related Influences on Left Ventricular Mechanics in Elderly Individuals Free of Prevalent Heart Failure: The ARIC Study (Atherosclerosis Risk in Communities). Circ Cardiovasc Imaging. 2017; 10(1). PMC: 5260486. DOI: 10.1161/CIRCIMAGING.116.004510. View

Zhang G, Shi K, Yan W, Li X, Li Y, Guo Y . Effects of diabetes mellitus on left ventricular function and remodeling in hypertensive patients with heart failure with reduced ejection fraction: assessment with 3.0 T MRI feature tracking. Cardiovasc Diabetol. 2022; 21(1):69. PMC: 9077817. DOI: 10.1186/s12933-022-01504-w. View

Levy P, Machefsky A, Sanchez A, Patel M, Rogal S, Fowler S . Reference Ranges of Left Ventricular Strain Measures by Two-Dimensional Speckle-Tracking Echocardiography in Children: A Systematic Review and Meta-Analysis. J Am Soc Echocardiogr. 2016; 29(3):209-225.e6. PMC: 4779733. DOI: 10.1016/j.echo.2015.11.016. View

Kane G, Karon B, Mahoney D, Redfield M, Roger V, Burnett Jr J . Progression of left ventricular diastolic dysfunction and risk of heart failure. JAMA. 2011; 306(8):856-63. PMC: 3269764. DOI: 10.1001/jama.2011.1201. View

Galderisi M, Schiano Lomoriello V, Santoro A, Esposito R, Olibet M, Raia R . Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study. J Am Soc Echocardiogr. 2010; 23(11):1190-8. DOI: 10.1016/j.echo.2010.07.010. View

10.

Taylor R, Moody W, Umar F, Edwards N, Taylor T, Stegemann B . Myocardial strain measurement with feature-tracking cardiovascular magnetic resonance: normal values. Eur Heart J Cardiovasc Imaging. 2015; 16(8):871-81. DOI: 10.1093/ehjci/jev006. View

11.

Ruilope L, Schmieder R . Left ventricular hypertrophy and clinical outcomes in hypertensive patients. Am J Hypertens. 2008; 21(5):500-8. DOI: 10.1038/ajh.2008.16. View

12.

Alcidi G, Esposito R, Evola V, Santoro C, Lembo M, Sorrentino R . Normal reference values of multilayer longitudinal strain according to age decades in a healthy population: A single-centre experience. Eur Heart J Cardiovasc Imaging. 2017; 19(12):1390-1396. DOI: 10.1093/ehjci/jex306. View

13.

Nadruz W . Myocardial remodeling in hypertension. J Hum Hypertens. 2014; 29(1):1-6. DOI: 10.1038/jhh.2014.36. View

14.

Ernande L, Bergerot C, Rietzschel E, De Buyzere M, Thibault H, Pignonblanc P . Diastolic dysfunction in patients with type 2 diabetes mellitus: is it really the first marker of diabetic cardiomyopathy?. J Am Soc Echocardiogr. 2011; 24(11):1268-1275.e1. DOI: 10.1016/j.echo.2011.07.017. View

15.

Nagueh S, Smiseth O, Appleton C, Byrd 3rd B, Dokainish H, Edvardsen T . Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016; 29(4):277-314. DOI: 10.1016/j.echo.2016.01.011. View

16.

Li G, Huang J, Sheng X, Fan L . Assessment of subclinical left ventricular myocardial systolic dysfunction in type 2 diabetes mellitus patients with or without hypertension by global and segmental myocardial work. Diabetol Metab Syndr. 2023; 15(1):200. PMC: 10571503. DOI: 10.1186/s13098-023-01180-0. View

17.

Hirt M, Sorensen N, Bartholdt L, Boeddinghaus J, Schaaf S, Eder A . Increased afterload induces pathological cardiac hypertrophy: a new in vitro model. Basic Res Cardiol. 2012; 107(6):307. PMC: 3505530. DOI: 10.1007/s00395-012-0307-z. View

18.

Cognet T, Vervueren P, Dercle L, Bastie D, Richaud R, Berry M . New concept of myocardial longitudinal strain reserve assessed by a dipyridamole infusion using 2D-strain echocardiography: the impact of diabetes and age, and the prognostic value. Cardiovasc Diabetol. 2013; 12:84. PMC: 3685519. DOI: 10.1186/1475-2840-12-84. View

19.

Potter E, Wright L, Yang H, Marwick T . Normal Range of Global Longitudinal Strain in the Elderly: The Impact of Subclinical Disease. JACC Cardiovasc Imaging. 2020; 14(1):300-302. DOI: 10.1016/j.jcmg.2020.07.014. View

20.

Voigt J, Pedrizzetti G, Lysyansky P, Marwick T, Houle H, Baumann R . Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2014; 16(1):1-11. DOI: 10.1093/ehjci/jeu184. View