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Layer-specific systolic and diastolic strain in hypertensive patients with and without mild diastolic dysfunction

Echo Research & Practice volume 5, pages 41–49 (2018)Cite this article

Abstract

This study sought to examine layer-specific longitudinal and circumferential systolic and diastolic strain, strain rate (SR) and diastolic time intervals in hypertensive patients with and without diastolic dysfunction. Fifty-eight treated hypertensive patients were assigned to normal diastolic function (NDF, N = 39) or mild diastolic dysfunction (DD, N = 19) group. Layer-specific systolic and diastolic longitudinal and circumferential strains and SR were assessed. Results showed no between-group difference in left ventricular mass index (DD: 92.1 ± 18.1 vs NDF: 88.4 ± 16.3; P = 0.44). Patients with DD had a proportional reduction in longitudinal strain across the myocardium (endocardial for DD −13 ± 4%; vs NDF −17 ± 3, P < 0.01; epicardial for DD −10 ± 3% vs NDF −13 ± 3%, P < 0.01; global for DD: −12 ± 3% vs NDF: −15 ± 3, P = 0.01), and longitudinal mechanical diastolic impairments as evidenced by reduced longitudinal strain rate of early diastole (DD 0.7 ± 0.2 L/s vs NDF 1.0 ± 0.3 L/s, P < 0.01) and absence of a transmural gradient in the duration of diastolic strain (DD endocardial: 547 ± 105 ms vs epicardial: 542 ± 113 ms, P = 0.24; NDF endocardial: 566 ± 86 ms vs epicardial: 553 ± 77 ms, P = 0.03). Patients with DD also demonstrate a longer duration of early circumferential diastolic strain (231 ± 71 ms vs 189 ± 58 ms, P = 0.02). In conclusion, hypertensive patients with mild DD demonstrate a proportional reduction in longitudinal strain across the myocardium, as well as longitudinal mechanical diastolic impairment, and prolonging duration of circumferential mechanical relaxation.

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Acknowledgments

The authors would like to thank Adele Oxborough for providing technical support for data analysis.

Funding

This project was funded by The British Heart Foundation (BHF) Grant (PG/11/66/28982). The BHF did not have any role in study design; collection, analysis and interpretation of data; writing the report and the decision to submit the report for publication.

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Authors and Affiliations

  1. Department of Kinesiology, Brock University, St Catharines, Ontario, Canada

    Hisham Sharif PhD & David Ditor PhD

  2. Health Sciences, Brock University, St Catharines, Ontario, Canada

    Deborah O’Leary PhD

  3. Division of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

    Stephen Ting MRCP PhD & Daniel Zehnder MD PhD

  4. Division of Metabolic and Vascular Health, The University of Warwick, Coventry, UK

    Stephen Ting MRCP PhD

  5. Department of Acute Medicine, Heart of England NHS Foundation Trust, Birmingham, UK

    Stephen Ting MRCP PhD

  6. Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

    Lynsey Forsythe MSc, Keith George PhD & David Oxborough PhD

  7. Centre for Applied Biological and Exercise Sciences, Coventry University, UK

    Gordon McGregor PhD

  8. Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry, UK

    Prithwish Banerjee MD

  9. Brock-Niagara Centre for Health and Well-Being, Brock University, St Catharines, Ontario, Canada

    Deborah O’Leary PhD & David Ditor PhD

  10. Department of Acute Medicine, North Cumbria University Hospital NHS Trust, Carlisle, UK

    Daniel Zehnder MD PhD

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  1. Hisham Sharif PhD
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  2. Stephen Ting MRCP PhD
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  6. Deborah O’Leary PhD
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  7. David Ditor PhD
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  10. David Oxborough PhD
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Correspondence to Hisham Sharif PhD.

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Sharif, H., Ting, S., Forsythe, L. et al. Layer-specific systolic and diastolic strain in hypertensive patients with and without mild diastolic dysfunction. Echo Res Pract 5, 41–49 (2018). https://doi.org/10.1530/ERP-17-0072

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  • DOI: https://doi.org/10.1530/ERP-17-0072

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Echo Research & Practice

ISSN: 2055-0464

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