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±105ms vs epicardial: 542±113ms, p=0.24; NDF endocardial: 566±86ms vs epicardial: 553±77ms, p=0.03). Patients with DD also demonstrate a longer duration of early circumferential diastolic strain (231±71ms vs 189±58ms, p=0.02). In conclusion, hhypertensive 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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- diastolic dysfunction
- transmural gradient
- layer-specific strain