Key result
Arterial hypertension was associated with significantly lower left ventricular global longitudinal strain (18.8% vs 20.2%; p<0.001) compared to normotensive individuals.
Why the study?
To evaluate changes in LV systolic function by LV myocardial GLS and GSR in patients with arterial hypertension and according to blood pressure control in individuals older than 55 years.
Does arterial hypertension and its control affect left ventricular global longitudinal strain and global strain rate in a population sample?
Cross-Sectional (n=1,004)
Does arterial hypertension and its control affect left ventricular global longitudinal strain and global strain rate in a population sample?
Arterial hypertension, particularly when inadequately controlled, is independently associated with early decline in left ventricular systolic function as measured by global longitudinal strain and strain rate.
Supports hypertension-GLS link for early detection; hypothesis-generating and requires prospective validation before practice change.
Aim To evaluate changes in left ventricular (LV) systolic function by LV myocardial global longitudinal strain (GLS) and global strain rate (GSR) in patients with arterial hypertension (AH) and based on the effectiveness of blood pressure (BP) control in a Russian population sample of individuals older than 55 years.Materials and methods This cross-sectional study was a population-based cohort study (HAPIEE, Novosibirsk). LV myocardial GLS and GSR were studied by echocardiography in a random sample (n=1004, 55-84 years). Statistical analysis was performed with multivariate models of logistic regression.Results AH prevalence in the study sample was 78.4 %. Mean GLS was 19.1 % (SD, 4.07), which was less for men than for women (p=0.001). Mean GSR was 0.86 s-1 (SD, 0.19) and was not different between men and women. In individuals with AH, the GLS absolute value was lower than in normotensive people (18.8 %; SD, 4.04 vs. 20.2 %; SD, 4.03, p˂0.001); these differences remained irrespective of the age, gender, body weight index (BWI) (p=0.027), and LV mass index (p=0.05). When people with AH were divided into groups, the lowest GLS absolute values were observed among "ineffectively treated" or not receiving any therapy individuals (p<0.001 vs. normotensive group). AH 1.6 times increased the risk of LV GLS decrease. In individuals with AH, the GSR absolute value was lower than in normotensive people (- 0.85 s-1 (SD, 0.19) vs.- 0.92 s-1 (SD, 0.18), p<0.001); this difference remained in multivariate models. The lowest GSR absolute values were observed in the "ineffectively treated" group irrespective of the gender, age, and BWI (p=0.036 vs. normotensive group). AH doubled the risk of LV GSR decrease, which could be partially explained by the contribution of BWI and myocardial mass index.Conclusion In this population sample, LV GLS and GSR were independently associated with AH. The lowest GLS and GSR values were observed for ineffectively treated" individuals with AH, which may reflect an early decline of LV systolic function with inadequate control of AH.
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Гусева et al. (2020) conducted a cross-sectional in Arterial hypertension (n=1,004). Arterial hypertension vs. Normotensive individuals was evaluated on Left ventricular myocardial global longitudinal strain (GLS) (p=<0.001). Arterial hypertension was associated with significantly lower left ventricular global longitudinal strain (18.8% vs 20.2%; p<0.001) compared to normotensive individuals.
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