Direct measurement of radial strain in the inner-half layer of the left ventricular wall in hypertensive patients

• Published in: Journal of cardiology 2012-01, Vol.59 (1), p.64-71
• Main Authors: Nishimura, Kazuhisa, MD, Okayama, Hideki, MD, FJCC, Inoue, Katsuji, MD, Saito, Makoto, MD, Yoshii, Toyofumi, MD, Hiasa, Go, MD, Sumimoto, Takumi, MD, FJCC, Inaba, Shinji, MD, Ogimoto, Akiyoshi, MD, FJCC, Funada, Jun-ichi, MD, FJCC, Higaki, Jitsuo, MD, FJCC
• Format: Article
• Language: English
• Subjects: Cardiovascular; Echocardiography - methods; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension - diagnostic imaging; Hypertension - pathology; Hypertension - physiopathology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - pathology; Left ventricular hypertrophy; Left ventricular mass index; Male; Middle Aged; Multivariate Analysis; Radial strain; Relative wall thickness; Speckle tracking echocardiography; Sprains and Strains; Stroke Volume
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2011.08.003

Summary Background Two-dimensional speckle tracking echocardiography (2D-STE) is a novel technology that directly measures regional left ventricular (LV) wall contraction. This study aimed to directly measure inner-layer thickening (radial strain) of the LV using 2D-STE, and to examine the relationship between radial strain and the degree of hypertrophy. Methods The study enrolled 63 untreated hypertensive patients with normal geometry ( N group, n = 32) or concentric hypertrophy (CH group, n = 31), classified according to LV mass index (LVMI) and relative wall thickness (RWT). Thirty normotensive subjects ( C group, n = 30) served as controls. Radial strain ( ε ) in the inner half ( εi ) and all layers of the LV wall ( εa ) were calculated from the LV short-axis view by 2D-STE. Results LV ejection fraction did not differ significantly among the groups. However, εi and εa were significantly lower in the CH group compared with the C and N groups ( p < 0.01). A ratio of εi to εa was significantly lower in the CH group compared with the C and N groups ( p < 0.01). A multivariate regression model that included midwall fractional shortening, E / e ′, LVMI, RWT, and LV ejection fraction showed that LVMI ( p = 0.002) and RWT ( p = 0.014) were independent predictors ( R2 = 0.59) of εi. Conclusion Radial strain in the inner half layer of the LV wall decreases in parallel with the degrees of LV concentricity and hypertrophy in hypertensive patients. Radial strain in the inner half layer may identify subtle systolic dysfunction even in hypertensive patients with preserved LV chamber function.