Vol. 46 | No. 2 | July-December 2018 Back

Open Access

Detection of Subclinical Ventricular Dysfunction Using Global Left Ventricular Strain in Patients with Controlled and Uncontrolled Hypertension

Michelle Angelique R. Romero-Sublett, Loewe Go
Dec 2018 DOI 10.69944/pjc.243308b34e

Abstract

BACKGROUND: Hypertension is closely linked to left ventricular (LV) hypertrophy, which can lead to overt  heart failure. The use of global longitudinal strain (GLS) in this subset of individuals seems to be able to detect subclinical changes, thereby allowing for more aggressive therapy. This study aimed to compare the GLS and other echocardiographic measures of patients with controlled and uncontrolled hypertension using Speckle Tracking Echocardiography (STE). 

METHODS: This was a cross-sectional study that included 56 hypertensive patients who underwent two dimensional echocardiography in a private hospital from 2016-2017. Blood pressure (BP) was taken in a comfortable sitting position after the initial screening and then five minutes thereafter. Patients were then classified as having controlled (BP<140/90 mmHg) or uncontrolled hypertension (BP≥140/90). Patients then underwent echocardiographic examination with speckle tracking to determine GLS. The echocardiographic measures and GLS of the two groups were then compared. 

RESULTS: Of the 56 patients recruited, 41 patients (73%) had controlled hypertension and 15 patients (27%)  had uncontrolled hypertension. Patients with uncontrolled hypertension had significantly higher E/e’ (p<0.01), IVS diastolic (p<0.05) and RWT values (p <0.05) compared to those with controlled hypertension. However, the GLS of patients with controlled hypertension was not significantly different from those with uncontrolled hypertension (--19.7 ± 3.04% vs -19.1 ± 2.29%; p=0.468). 

Conclusion: Patients with uncontrolled hypertension had significantly higher E/e’, IVS diastolic and RWT  values compared to those with controlled hypertension. However, the GLS of patients with controlled hypertension was not significantly different from those with uncontrolled hypertension.

 

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