ASSESSMENT OF THE LEFT VENTRICLE SYSTOLIC FUNCTION WITH ULTRASOUND 2D-STRAIN TECHNOLOGY IN ARTERIAL HYPERTENSION

Aim. The assessment of global longitudinal deformation and velocity of deformation of the left ventricle (LV) in arterial hypertension (AH) patients for diagnostics of preclinical systolic function disorders.

Material and methods. Totally, 105 AH patients investigated, age 53,3±5,7 y. o., and 35 age and gender matched almost healthy persons. All patients underwent standard clinical and functional investigation with evaluation of diastolic and systolic function with additional assessment of global longitudinal deformation of theLV.

Results. In AH theLVhypertrophy (LVH) more often was associated with the male gender and higher levels of arterial pressure, which required prescription of combination antihypertension therapy. In 19 (32,8%) of LVH patients there was increased volume of the left atrium more than 34 mL/m2 , of E/e’ value more 10 and systolic pressure in pulmonary artery more 35 mmHg, that witnessed on the increase of pulmonary artery wedge pressure increase. Of those 9 (15,5%) patients with concentric LVH complained on dyspnea and exercise intolerance related to chronic heart failure and normal ejection fraction, but with decreased longitudinal deformation of LV (-16,3±0,8%). Global longitudinal deformation in normal geometry of the LV was -19,5±0,9% and was significantly higher than in concentric remodeling (-18,3±0,9%), concentric (-17,6±0,9%) and excentric (-18,7±0,7%) LVH.

Conclusion. In AH the application of 2D-strain makes it to reveal the disorders of longitudinal systolic LV function even before hypertrophy development, though more significant decrease of global longitudinal deformity of LV is marked in its concentric hypertrophy. In chronic heart failure with saved ejection fraction, together with disordered systolicLVfunction there is a decrease of its longitudinal deformation. 

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