Evaluation of Left ventricular systolic function by Myocardial Deformation Imaging in Hypertensive patients with Preserved Left Ventricular Ejection Fraction

Background and Aims: Hypertension being one of the commonest non communicable diseases is major risk factor leading to premature death.1 With development of, the left ventricular strain imaging technique by echocardiography the consequences of hypertension may be identified and intervene earlier. The aim of study was to show abnormalities in cardiac function in the form of left ventricular strain imaging in hypertensive patients with preserved Ejection fraction. Methods: This was a cross-sectional, comparative and observational study done in Shahid Gangalal National Heart Centre and National Academy of Medical Sciences, Bir Hospital Kathmandu which included hypertensive patients with baseline examination including a medical history, clinical examination and a standardized trans thoracic echocardiography and strain imaging examination and the findings were compared among age and sex frequency matched 82 healthy adults in 1 : 2 ratio. The independent paired t test was used for the comparative statistical analysis. Results: We enrolled 240 patients in this study, 158 were hypertensive (mean age 48.5 ±6.1 years with 50.6 % female) and 82 healthy control (mean age 45.62 ±6.3 years with 51.2% female). There was no significant difference in conventional echocardiographic parameters between two groups except for left ventricular mass index and relative wall thickness that was highest in hypertensive group (p value of <0.001). The hypertensive population has lower mean global longitudinal strain (GLS) value of -18.6% ± 2.06 SD compared to the healthy control population with mean of -19.5% ± 1.1 SD (p value of <0.001). Conclusion: Hypertensive patients with preserved left ventricular ejection fraction have subclinical left ventricular dysfunction revealed by GLS imaging technique.

Strain Analysis Using Feature Tracking Cardiac Magnetic Resonance Predict Prognosis of Patients With Ventricular Aneurysm After Myocardial Infarction

Objective We aim to assess the left ventricular strain in patients with ventricular aneurysm(VA) after myocardial infarction(MI) using cardiac magnetic resonance-feature tracking (CMR-FT) and to evaluate its value for long term prognosis of patients.Methods Sixty-five patients who underwent CMR with VA after MI from January 2018 to December 2019 in Drum Tower Hospital Affiliated Hospital of Nanjing University School of Medicine were selected for the study. They were divided into two groups based on New York Heart Association (NYHA): 25 cases of NYHA I as group A and 40 cases of NYHA II-IV as group B. CMR was performed in both groups to quantify the parameters of overall and segmental left ventricular myocardial strain in patients with aneurysm. 37 of whom underwent a second CMR 3-12 months after cardiac infarction to investigate the effects of aneurysm on patients' left ventricular strain and left ventricular cardiac function.Results Patients from group B have larger VA basilar transverse diameter and significant more impaired LV Global longitudinal strain(GLS)、Global circumferential strain(GCS)、Global radial strain(GRS) (-12.34±7.31 vs. -7.68±6.11;p=0.0072, -21.31±13.49 vs. -14.93±10.44;p=0.0361, 37.13±27.87 vs. 22.00±20.05;p=0.0135) without change in infarct size. GLS, GCS, GRS were significant indicators of NYHA classification after AMI by multivariate regression analysis.Conclusions Myocardial strain assessed by CMR-FT may be an independent predictor of NYHA of patients with aneurysm after MI and could be used for identifying high-risk patients with VA.

Diagnostic value of left ventricle strain pattern of hypertensive patients in coronary and cerebrovascular diseases

Association of Electrocardiographic Left Ventricular Strain Pattern with Coronary Artery Disease and Cerebrovascular Accident in Hypertensive Patients Background: Patients diagnosed with hypertension and left ventricular hypertrophy could presented with electrocardiographic changes including criteria of left ventricular hypertrophy, and left ventricular strain pattern( fixed ST depression and T inversion in leads I, avL, V5&6) Objective: To study the impact of electrocardiographic left ventricular strain pattern in hypertensive patient as predictor for coronary artery disease and cerebrovascular accident development. Material and method: a cross sectional hospital based study was conducted during 2012-2017 at Iraqi center for heart diseases including hypertensive patients with normal ECG or LV strain pattern criteria, all patients underwent echocardiography and coronary angiography and the data were collected from patients’ files. Results: The records of 401 hypertensive patients [262(65.3%) males/139(34.7%) females] were included in this study. Their mean age was 60.07 ± 10.8 year. The relation between electrocardiographic left ventricular strain pattern and Coronary Angiography among patients was significant (P <0.001). There was a significant difference between electrocardiographic left ventricular strain pattern and cerebrovascular accident among studied group (P<0.001). Conclusions: electrocardiographic left ventricular strain in hypertensive patients is highly associated with coronary artery disease and cerebrovascular accident. .