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Updated: May 4, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection
Susana Gonçalves1, Nuno Cortez-Dias2, Ana Nunes3
1Departamento de Cardiologia, Instituto Cardiovascular de Lisboa, Lisboa, Portugal; Serviço de Cardiologia, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, CCUL, Lisboa, Portugal.
Insights
Global myocardial strain parameters identified subclinical left ventricular systolic dysfunction in hypertensive patients with preserved ejection fraction. Further studies are needed to assess the clinical relevance of these early changes.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Hypertensive heart disease encompasses a range of conditions, including left ventricular dysfunction.
- Echocardiographic parameters are crucial for stratifying patients and detecting early adverse changes.
- Identifying subclinical left ventricular dysfunction in hypertensive individuals is clinically significant.
Purpose of the Study:
- To identify subclinical left ventricular dysfunction in hypertensive patients with preserved ejection fraction (>55%).
- To utilize global myocardial strain parameters from speckle tracking imaging for early detection.
- To improve patient stratification in hypertensive heart disease.
Main Methods:
- Comparative observational study involving normotensive (n=20) and hypertensive (n=229) groups.
- Assessment of left ventricular function using conventional echocardiography and global longitudinal/circumferential myocardial strain.
- Establishment and application of cut-off values for subclinical dysfunction detection in the hypertensive cohort.
Main Results:
- No significant differences in global longitudinal or circumferential systolic strain between groups.
- Application of cut-offs revealed subclinical left ventricular systolic dysfunction in 15.3% (35 individuals) of the hypertensive group.
- A significant portion of hypertensive subjects (53.7%) had grade I hypertension, with 64.9% controlled blood pressure and 54.8% showing structural changes.
Conclusions:
- Global myocardial strain parameters effectively identified subclinical left ventricular systolic dysfunction in hypertensive patients with preserved ejection fraction.
- These findings highlight the potential of strain imaging for early detection of cardiac changes in hypertension.
- Long-term follow-up studies are required to determine the clinical significance of these identified dysfunctions.
Introduction:
The spectrum of hypertensive heart disease is wide, and can include left ventricular dysfunction. The development of echocardiographic parameters to improve patient stratification and to identify early adverse changes could be clinically useful. Aim To identify subclinical left ventricular dysfunction in hypertensive subjects with preserved ejection fraction (>55%), identified by global parameters of myocardial strain on speckle tracking imaging.
Methods:
This was a comparative observational study of two groups of individuals: normotensive (n=20, age 59 ± 7 years, 55% male) and hypertensive (n=229, age 62 ± 12 years, 57% male). Left ventricular function was assessed by various conventional clinical and echocardiographic parameters and global longitudinal and circumferential myocardial strain. Cut-off values to detect subclinical left ventricular dysfunction were established and applied in the hypertensive group. The Student's t test, Mann-Whitney test and chi-square test were used for the comparative statistical analysis.
Results:
Most hypertensive subjects (53.7%) had grade I hypertension; blood pressure was controlled in 64.9%, and 54.8% showed left ventricular structural changes. Comparison between the normotensive and hypertensive groups showed no significant differences in parameters of global longitudinal or circumferential systolic strain. Application of the cut-offs to the hypertensive group identified 35 individuals (15.3%) as having subclinical left ventricular systolic dysfunction as assessed by global longitudinal myocardial strain parameters.
Conclusions:
In this group of hypertensive patients, global myocardial strain parameters identified a group of individuals with subclinical left ventricular systolic dysfunction despite preserved ejection fraction. The clinical relevance of these findings needs to be assessed in long-term follow-up studies.
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