Systemic hypertension was associated with significantly impaired left ventricular global longitudinal strain compared to normotensive controls (SMD 1.07; 95% CI 0.77-1.36; P<0.0001).
Meta-Analysis (n=4,276)
Does two-dimensional speckle tracking echocardiography detect impaired global longitudinal strain in uncomplicated hypertensive patients compared to normotensive controls?
GLS assessment by speckle tracking echocardiography unmasks subclinical systolic dysfunction in uncomplicated hypertension that is undetected by conventional ejection fraction.
Standardized Mean Difference: 1.07 (95% CI 0.77–1.36)
p-value: p=< 0.0001
AIM: Available evidence on systolic dysfunction in systemic hypertension, as assessed by left ventricular (LV) mechanics, is still based on single studies. Thus, we performed a systematic meta-analysis of two-dimensional speckle-tracking studies in order to provide an updated comprehensive information on this issue. METHODS: The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English language articles published from the inception up to 31 December 2020. Studies were identified by using MeSH terms and crossing the following search items: 'myocardial strain', 'left ventricular mechanics', 'speckle tracking echocardiography', 'systolic dysfunction', 'hypertensive heart disease', 'systemic hypertension', 'essential hypertension'. RESULTS: Data from 4276 individuals (2089 normotensive controls and 2187 mostly uncomplicated hypertensive patients) were included. Left ventricular (LV) mass index, relative wall thickness, left atrial volume index and E/e' ratio were significantly higher in hypertensive patients than in normotensive controls. LV ejection fraction did not differ in the two pooled groups (SMD -0.048 ± 0.054, 95% CI -0.20 to 0.10, P = 0.30), whereas LV global longitudinal strain (GLS) was significantly impaired in the hypertensive group (SMD: 1.07 ± 0. 15, 95% CI 0.77-1.36, P < 0.0001). Similar findings were obtained in a sub-analysis restricted to 15 studies in which mean age was similar in cases and controls (SMD 1.21 ± 0.23, 95% CI 0.76-1.67, P = 0.002). CONCLUSION: The present meta-analysis suggests that GLS assessment unmasks systolic dysfunction undetected by conventional ejection fraction in the uncomplicated hypertension setting and that this parameter should be incorporated into routine work-up aimed to identify hypertension-mediated cardiac damage.
Tadić et al. (Fri,) conducted a meta-analysis in Systemic hypertension (n=4,276). Systemic hypertension vs. Normotensive controls was evaluated on Left ventricular global longitudinal strain (GLS) (SMD 1.07, 95% CI 0.77-1.36, p=< 0.0001). Systemic hypertension was associated with significantly impaired left ventricular global longitudinal strain compared to normotensive controls (SMD 1.07; 95% CI 0.77-1.36; P<0.0001).
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