P235Relation between myocardial deformation by three-dimensional speckle tracking analysis , control of the hypertension and functional capacity in patients with systemic hypertension.

The purpose of this study was to investigate left ventricular (LV) function in hypertensive patients by 3-dimensional (3D) speckle tracking imaging, and determine the relation between the LV mechanics and functional capacity in this population. This cross-sectional study included 20 treated subjects with well-controlled arterial hypertension (group B) and 20 treated participants with uncontrolled hypertension (group A), adjusted by gender and age. All the subjects underwent 24-hour blood pressure monitoring, complete 2-dimensional and 3D examination, and exercise testing. Patients had similar 3D LV ejection fraction. LV mass was higher in group of uncontrolled hypertension (154.71 ± 49.7 g/m2 versus 147.12±44.8 g/m2 p < 0.01), as well as E/E'ratio (11.4 versus 8.9, p =0.02). 3D global longitudinal and circumferential strain and strain rate were significantly decreased in patients with inadequately controlled hypertension (LS 16.25% versus -19.24%, p=0.007, L-SR -0.97/sec versus -1.48/sec, p=0.04, CS -17.89%versus -21.76%, p=0.04, respectively), while the difference of radial strain and strain rate did not reach statistical significance. Group A of patients had also a significantly lower functional capacity (mean duration of test 13,3 min. versus 17,4 min, nr. of METS 9.4 versus 13.7). Duration of exercise was independently associated with LV mass , mean BP at daytime , E/E' ratio and 3D global longitudinal strain (β = 0.34, p = 0.02) in the whole hypertensive population in our study. In conclusion, LV longitudinal strain and functional capacity are significantly impaired in the patients with uncontrolled hypertension in comparison with the well-controlled hypertensive patients and are independently associated.