Left ventricular mechanics in asymptomatic normotensive and hypertensive patients with aortic regurgitation

The aims of this study were to detect subclinical left ventricular (LV) dysfunction and to determine the impact of arterial hypertension on LV systolic function using speckle-tracking echocardiography in patients with chronic aortic regurgitation (AR).

Sixty-eight patients with AR and 47 healthy controls were included in the study. LV rotation and longitudinal, radial, and circumferential strain were measured using speckle-tracking imaging.

Longitudinal axis dysfunction was found in patients with moderate AR with hypertension but was not present in patients with moderate AR without hypertension. Radial strain in patients with moderate AR was unchanged, but reduced levels were noted at the apical level in patients with severe AR without hypertension and preserved in those with severe hypertensive AR. LV basal rotation was reduced in patients with severe AR, whereas apical rotation was increased in those with moderate AR. LV torsion was reduced in patients with severe AR.

Patients with asymptomatic AR show subclinical LV longitudinal axis dysfunction, with more attenuation demonstrated in hypertensive than in normotensive patients.