The Predictive Value of Global Longitudinal and Circumferential Strains in Hypertensive Patients: 10-Year Follow-Up

Background: The aim of the current study was to investigate the predictive value of a multidirectional LV strain on adverse outcomes in a large population of uncomplicated hypertensive patients who were followed for a mean period of 10 years. Methods: This retrospective study included 591 recently diagnosed hypertensive patients who underwent clinically indicated echocardiography between January 2010 and December 2014 and were followed for a mean period of 10 years. Global longitudinal, circumferential and radial strains (GLS, GCS and GRS) were measured by 2D speckle tracking imaging. The primary outcome was a MACE occurrence defined by all-cause mortality, cardiovascular mortality, myocardial infarction, coronary artery by-pass, coronary stent implantation, stroke, development of heart failure and the occurrence of atrial fibrillation during follow-up. Results: Our results showed that GLS, GCS and GRS were significantly lower in patients who experienced MACE. Age, male gender, systolic blood pressure, left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) were associated with MACE occurrence. Reduced GLS [OR 1.15; 95%CI: 1.01-1.30] and reduced GCS [OR 1.1; 95%CI: 1.02-1.22] were related with MACE independently of clinical characteristics, LV systolic and diastolic function, as well as LVH. Reduced GRS was not independently associated with adverse outcomes. Conclusions: Reduced GLS and GCS were independently associated with adverse outcomes during 10-year follow-up in patients who were recently diagnosed and uncomplicated hypertensive patients at the baseline.