E.G. Nesukay, Y.Y. Hiresh. Evaluation of left heart function in patients with different types of left ventricular hypertrophy by speckle-tracking echocardiography

The aim – to assess the structural and functional state of the left heart in patients with essential hypertension (EH) with different types of left ventricular hypertrophy (LVH).

Material and methods. The study involved 80 patients with essential hypertension (women – 59 %), average age 57.2±1.03 years. According to the type of LVH patients were divided into four groups. The 1st group consisted of 20 patients without LVH, the 2nd – 25 pts with mild LVH, the 3rd – 20 pts with moderate LVH, and the 4th – 15 pts with severe LVH. In all patients we performed echocardiography (Echo) and speckle-tracking Echo with analysis of longitudinal global systolic strain (LGSS), circumferential global systolic strain (CGSS) and their rates (LGSSR and CGSSR respectively), early and late diastolic strain rate (SR) of LV, early and late diastolic SR of left atrium (LA), LA systolic deformation.

Results and conclusion. In patients with different degrees of LVH we observed the following changes: in the second group with mild LVH a decrease of LGSS and early diastolic LV SR was found and these changes were more expressed in groups with moderate and severe LVH. Moderate LVH was characterized also by the significant decrease of LGSSR and CGSSR. In patients with severe LVH we recorded the lowest values of LGSS, CGSS and CGSSR, compared to those in other groups. Changes of reservoir and conduit LA function were found in hypertensive patients even without LVH, these changes became more pronounced with more severe LVH. In patients with severe LVH we observed also impairment of LA contractile function.

Conclusions. Application of speckle-tracking echocardiography in hypertension pts with LVH and preserved EF allows to reveal changes of longitudinal function, diastolic dysfunction, increase of LV filling pressure already at stage of mild LVH. These changes were most significant in group of severe LVH. Changes of reservoir and conduit LA function increased along with more severe LVH. Contractile LA dysfunction was marked only in group with severe LVH.

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