Layer-specific systolic and diastolic strain in hypertensive patients with and without mild diastolic dysfunction

摘要

This study sought to examine layer-specific longitudinal and circumferential systolic and diastolic strain, strain rate (SR) and diastolic time intervals in hypertensive patients with and without diastolic dysfunction. Fifty-eight treated hypertensive patients were assigned to normal diastolic function (NDF, N?=?39) or mild diastolic dysfunction (DD, N?=?19) group. Layer-specific systolic and diastolic longitudinal and circumferential strains and SR were assessed. Results showed no between-group difference in left ventricular mass index (DD: 92.1?±?18.1 vs NDF: 88.4?±?16.3; P?=?0.44). Patients with DD had a proportional reduction in longitudinal strain across the myocardium (endocardial for DD ?13?±?4%; vs NDF ?17?±?3, P??0.01; epicardial for DD ?10?±?3% vs NDF ?13?±?3%, P??0.01; global for DD: ?12?±?3% vs NDF: ?15?±?3, P?=?0.01), and longitudinal mechanical diastolic impairments as evidenced by reduced longitudinal strain rate of early diastole (DD 0.7?±?0.2?L/s vs NDF 1.0?±?0.3?L/s, P??0.01) and absence of a transmural gradient in the duration of diastolic strain (DD endocardial: 547?±?105?ms vs epicardial: 542?±?113?ms, P?=?0.24; NDF endocardial: 566?±?86?ms vs epicardial: 553?±?77?ms, P?=?0.03). Patients with DD also demonstrate a longer duration of early circumferential diastolic strain (231?±?71?ms vs 189?±?58?ms, P?=?0.02). In conclusion, hypertensive patients with mild DD demonstrate a proportional reduction in longitudinal strain across the myocardium, as well as longitudinal mechanical diastolic impairment, and prolonging duration of circumferential mechanical relaxation.