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Relation between hypertension and systolic and diastolic left ventricular function including segmental strain and strain rate
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  • Assami Rösner,
  • Michael Kornev,
  • Hatice Akay Caglayan,
  • Alexander Kudryavtsev V,
  • Sofia Malyutina,
  • Andrew Ryabikov,
  • Henrik Schirmer
Assami Rösner
Universitetssykehuset Nord-Norge

Corresponding Author:[email protected]

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Michael Kornev
Universitetssykehuset Nord-Norge
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Hatice Akay Caglayan
Universitetssykehuset Nord-Norge
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Alexander Kudryavtsev V
UiT Norges arktiske universitet
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Sofia Malyutina
Siberian Branch of the Russian Academy of Sciences
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Andrew Ryabikov
Siberian Branch of the Russian Academy of Sciences
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Henrik Schirmer
Akershus Universitetssykehus HF
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Background Left ventricular (LV) systolic and diastolic functions are important cardiovascular risk predictors in patients with hypertension. However, data on segmental, layer-specific strain, and diastolic strain rates in these patients are limited. The aim of this study was to investigate segmental two-dimensional strain rate imaging (SRI)-derived parameters to characterize LV systolic and diastolic function in hypertensive individuals compared with that in normotensive individuals. Methods The study sample comprised 1194 participants from population studies in Arkhangelsk and Novosibirsk, Russia, and 1013 individuals from the Seventh Tromsø Study in Norway. The study population was divided into four subgroups: A. healthy individuals with normal blood pressure (BP), B. individuals on antihypertensive medication with normal BP, C. individuals with systolic BP 140–159 mmHg and/or diastolic BP >90 mm HG, and D. individuals with systolic BP ≥160 mmHg. In addition to conventional echocardiographic parameters, global and segmental layer-specific strains and strain rates in early diastole and atrial contraction (SR E, SR A) were extracted. The strain and SR (S/SR) analysis included only segments without strain curve artifacts. Results With increasing BP, the systolic and diastolic global and segmental S/SR gradually decreased. SR E, a marker of impaired relaxation, showed the most distinctive differences between the groups. In normotensive controls and the three hypertension groups, all segmental parameters displayed apico-basal gradients, with the lowest S/SR in the basal septal and highest in apical segments. Only SR A did not differ between the segmental groups but increased gradually with increasing BP. End-systolic strain showed incremental epi-towards endocardial gradients, irrespective of the study group. Conclusion Arterial hypertension reduces global and segmental systolic and diastolic left ventricular S/SR parameters. Impaired relaxation determined by SR E is the dominant factor of diastolic dysfunction, whereas end-diastolic compliance (by SR A) does not seem to be influenced by different degrees of hypertension. Segmental strain, SR E and SR A provide new insights into the LV cardiomechanics in hypertensive hearts.
08 Dec 2022Submitted to Echocardiography
23 Dec 2022Submission Checks Completed
23 Dec 2022Assigned to Editor
29 Dec 2022Reviewer(s) Assigned
04 Mar 2023Editorial Decision: Revise Major
28 Mar 20231st Revision Received
31 Mar 2023Submission Checks Completed
31 Mar 2023Assigned to Editor
31 Mar 2023Reviewer(s) Assigned
07 May 2023Review(s) Completed, Editorial Evaluation Pending
10 May 2023Editorial Decision: Accept