title: Progression of left ventricular functional abnormalities in hypertensive patients with heart failure: an ultrasonic two-dimensional speckle tracking study.
abstract: OBJECTIVE
  Two-dimensional (2-D) strain imaging is a novel echocardiographic technique for myocardial function evaluation. We sought to investigate left ventricular (LV) systolic function in patients with heart failure caused by hypertension using a 2-D strain approach and to validate this method against Doppler strain measurements.
  
  
  METHODS
  The study population comprised 81 patients (66.4 +/- 7.4 years) with hypertension in New York Heart Association (NYHA) class I to IV and 20 healthy controls.
  
  
  RESULTS
  Decreased longitudinal strain was demonstrated in the basal septal segment in NYHA I, in the basal and mid septal and basal lateral segments in NYHA II, and in all segments in NYHA III and IV. Radial and circumferential strain were reduced in patients with NYHA III and IV. Independent predictors of strain were duration of HT, LV mass index, LV end-diastolic volume index, and systolic blood pressure. The agreement between 2-D and Doppler strain remained within acceptable ranges (mean difference +/- 1 standard deviation: 0.61%-1.92% +/- 2.38%-2.92% for longitudinal strain in particular segments and 4.98% +/- 5.26% for radial strain).
  
  
  CONCLUSIONS
  In hypertensive patients, (1) LV longitudinal systolic function progressively deteriorates from NYHA I to IV and abnormalities commence in the basal septum, (2) LV radial and circumferential systolic impairment appears in NYHA III and IV, and (3) 2-D strain measurement provides a feasible tool for the quantitation of LV systolic performance.
authors.affiliation: Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland. kosmw@kard.am.wroc.pl
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kosmala
authors.forename: Rafal
authors.initials: R
authors.lastname: Plaksej
authors.forename: Joerg M
authors.initials: JM
authors.lastname: Strotmann
authors.forename: Carla
authors.initials: C
authors.lastname: Weigel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Herrmann
authors.forename: Marcus
authors.initials: M
authors.lastname: Niemann
authors.forename: Hanna
authors.initials: H
authors.lastname: Mende
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.forename: Christiane E
authors.initials: CE
authors.lastname: Angermann
authors.forename: Jens A
authors.initials: JA
authors.lastname: Wagner
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
mesh_terms: D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*