Early Detection Of Right Ventricular Dysfunction In Newly Diagnosed Patients With Essential Hypertension Using Global Longitudinal Systolic Strain

Objective: Accurate assessment of right ventricular (RV) systolic function is important, as it is an established prognostic marker in cardiac diseases. Speckle-tracking echocardiography is a sensitive tool for detection of subclinical left ventricular impairment in essential hypertension. We evaluated RV function using global longitudinal peak systolic strain (GLS) in newly diagnosed patients with essential hypertension. Design and method: We included 23 patients (14 male, mean age 67 ± 10 years) with essential hypertension and 21 healthy individuals (15 male, mean age 66 ± 11 years. Standard echocardiography and 2D speckle tracking echocardiography with evaluation of longitudinal strain in each segment of the RV (basal: RVLS-B; mid: RVLS-M, apical: RVLS-A) and global RV free-wall strain (RVLS-G) were performed. Results: RVLS-G, RVLS-B and RVLS-M were significantly lower in hypertensives compared to controls (−18.67 ± 5.78 vs 21.60 ± 5.2, −11.72 ± 3.73 vs −19.60 ± 3.9 −16.32 ± 5.41 vs −21.60 ± 5.9, p < 0.5 for all). No significant difference was detected for the RVLS-A (−20.12 ± 3.2 for hypertensives vs −22.31 ± 3.54 for controls, p = NS). In addition, we detect a significant negative correlation between RVLS-G and ledt ventricular mass index (r = 0.57, p = 0.001). Conclusions: Essential hypertension leads to an early decrease RVLS-B and RVLS-M which is strongly correlated with the presence of left ventricular hypertrophy. Future studies are needed to assess the prognostic significance of these findings and the effects of treatment.