Subendocardial systolic dysfunction in hypertensive patients with strain ST-T changes on ECG by speckle tracking

ObjectiveThe aim of this study was to evaluate longitudinal strain by speckle tracking in hypertensive patients with strain ST-T on ECG.BackgroundHypertension causes ST-T changes on ECG which may predict subclinical systolic dysfunction detected by two-dimensional speckle tracking.Patients and methodsLongitudinal strain analysis was done in 82 hypertensive patients, who were divided into three groups: the first group included 30 hypertensive patients with echocardiographic evidence of left ventricular hypertrophy (LVH) and strain ST-T changes on ECG (group 1), the second included 31 hypertensive patients with echocardiographic evidence of LVH but without changes on ECG (group 2), and the third control group included 21 hypertensive patients without echocardiographic evidence of LVH (group 3).ResultsA high significant difference was detected in relation to hypertension duration, which divided into two categories (>10 and ≤10 years) (P < 0.001). A highly significant increase was present regarding echocardiography data on left ventricular (LV) mass (P < 0.001), LV mass index (P < 0.001), relative wall thickness (P < 0.001) and interventricular septum (P < 0.001), posterior wall (P < 0.001), left atrium (P < 0.001), and aorta diameters (P < 0.001) between group 1 compared with group 2 and group 3. Moreover, significant decrease was found on Doppler data regarding E/A ratio between group 1 compared with group 2 and group 3. There was a highly significant reduction between group 1 compared with group 2 and group 3 regarding mean value of global and regional LV longitudinal systolic strain (P < 0.001).ConclusionSubtle LV systolic dysfunction evident by speckle tracking was present in hypertensive patient with strain ST-T changes on ECG independent of left ventricular ejection fraction percentage.