Early predictors of left ventricular dysfunction in hypertensive patients: comparative cross-section study.

Identifying hypertensive patients who are at higher risk and thus to assess early echocardiographic markers of LV dysfunction in this population. Our comparative cross-section study included 100 patients divided into two groups; Group1: Hypertensive with preserved ejection fraction (EF) (n = 50) & Group 2: Normotensive (Control) (n = 50). Who underwent 2D Echo imaging with analysis of multible parameters of LV systolic and diastolic function including: left atrial volume index (LAVI), LV mass index, relative wall thickness, LV systolic function (EF%), diastolic function (trans-mitral pulsed and tissue Doppler study of E, A, e'-wave velocities& E/A, E/e' ratios), Global myocardial longitudinal strain (GLS) by speckle tracking echocardiography (STE) and the early diastolic driving force (DF) which calculated as (DF = mass × acceleration; DF = 0.004E/DT). We reported significant differences between the two groups in LV mass, LA volume and DF, which were all elevated in the hypertensive group, as well as reduced GLS magnitude. We also reported that a GLS cutoff of > - 18.1% was able to accurately "predict subclinical LV systolic dysfunction". Finally, DF showed a moderate correlation (r = 0.33, which was established with statistical confidence) with E/e' ratio, and a DF cutoff of ≥ 0.25 N was able to accurately "predict subclinical diastolic dysfunction". GLS cutoff > - 18.1% could be used for early prediction of LV systolic dysfunction in hypertensive. The early diastolic DF cutoff ≥ 0.25 N could be a useful tool for early prediction of LV diastolic dysfunction in hypertensive. These sensitive parameters could be used for early diagnosis and proper management for better outcomes.