Evaluation of functional indices of left ventricular wall layers using
layer-specific strain analysis in normotensive and hypertensive patients
Abstract
Background: In systemic hypertension, left ventricular remodeling
results in an increase in ventricular wall thickness due to augmented
ventricular afterload. Most studies on myocardial function in
hypertensives are performed using imaging techniques in which the
evaluation of myocardial wall thickness is performed without separating
the LV myocardial triple layers from the endocardium to the pericardium.
The specific myocardial function of each layer or layer-specific in both
segmental and global form can also be examined using left ventricular
strain analysis. The purpose of the present study was to evaluate the
functional indices of each layer of the left ventricular myocardium
using layer-specific strain analysis and also to evaluate the
relationship between ventricular structural remodeling with the
functional changes of the ventricle in each layer of the myocardium in
hypertensive and normotensive individuals. Methods: Eighty eight
patients (46.6% were normotensive and 53.4% were hypertensive)
underwent two-dimensional echocardiography and longitudinal and
circumferential strain indices were analyzed in all three layers . All
parameters evaluated in terms of diastolic dysfunction were compared
between two groups. Results: In patients with diastolic dysfunction, GLS
and GCS strains significantly decreased in epicardial and mid myocardial
layers in hypertensive patients, but these changes did not revealed in
those without diastolic dysfunction. Conclusion: Decreases in GLS and
GCS indices of the ventricular wall in mid myocardium and epicardial
layers are predictable in the context of hypertension, and these changes
in strain are evident in patients with ventricular diastolic dysfunctio