Evaluation of left ventricular systolic function in patients with hypertension by layer-specific strain and transmural gradient

Objective To investigate the value of ultrasonic two-dimensional speckle tracking imaging(2D-STI) layer-specific strain and transmural gradient in evaluating the changes of hypertensive patients′ left ventricular three layers myocardial function. Methods Thirty-five hypertensive patients without renal insufficiency were selected as group A, and 25 hypertensive patients with renal insufficiency as group B. For comparison, 40 healthy volunteers were gathered as control group. Then, the systolic peak longitudinal strain of the left ventricle(LPS), endocardium(LPSEndo), mid-cardium(LPSMid) and epicardium(LPSEpi) were collected.After that, features of transmural gradient(ΔLS) and its percentage(ΔLS%) were analyzed. Results For each group, gradient features exist in each layer of left ventricular myocardium: LPSEndo>LPSMid>LPSEpi. For each group, the differences between LPSEndo and LPSMid, and that between LPSEndo and LPSEpi were both statistically significant(P 0.05). Compared with control group, the ΔLS%Endo-Mid of group A rised, and the ΔLS%Endo-Mid, ΔLS%Mid-Epi of group B rised, the differences were statistically siginificant(all P<0.05). Compared with group A, the ΔLS%Endo-Mid, ΔLS%Mid-Epi of group B rised, the differences were statistically siginificant(all P<0.05). Conclusions The layer-specific strain technique can quantitatively evaluate the changes of systolic function of the left ventricular myocardium in hypertensive patients. ΔLS% may have better sensitivity than ΔLS in dection of systolic function damage of the left ventricular myocardium and can provide more reference for the evaluation of left ventricular systolic function. Key words: Echocardiography; Hypertension; Ventricular function, left; Layer-specific strain; Transmural gradient