ABSTRACT

Objectives: The aim of this study is to explore and compare the relationships of both global longitudinal strain (GLS) and strain (SR) with E/e’ ratio in a population of asymptomatic patients with systemic hypertension.

Methods: Retrospectively included 210 cases of essential hypertension patients. Dynamic images were analyzed for left ventricular myocardial systolic global longitudinal strain (GLS), left ventricular longitudinal peak systolic strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa). According to the 2012 baseline E/e’ ratio, the population was divided into three groups, group A (E/e’<8), group B (8 ≤ E/e’≤14), and group C (E/e’>14).

Results: Systolic function parameters left ventricular ejection fraction (LVEF) remained at normal rage and no different, but patients with elevated E/e’ ratio had significantly lower GLS, lower early diastolic strain rate(SRe), lower ratio of early diastolic strain rate to late diastolic strain rate (SRe/a) and higher E/SRe. Positive relationships were observed between GLS, E/SRe and E/e’ ratio, inverse relationships were observed between SRe, SRe/a and E/e’ ratio. E/SRe >0.73 had a sensitivity of 87.7% and a specificity of 38.2% for predicting an elevated E/e’ ratio (E/e’>14). In multivariable analysis, IVS-e’ <7 cm/s showed almost 2.5-fold increased risk for decreased GLS (OR 2.48[95% CI 1.36–4.53]; p = 003).

Conclusions: Our current study demonstrated that hypertensive patients with preserved LVEF and elevated E/e’ ratio have systolic and diastolic abnormalities in longitudinal directions as detected by speckle imaging. E/SRe correlates well with E/e’ and predicted elevated left ventricular filling pressure.

摘要

目的：本研究的目的是探索和比较整体纵向应变 (GLS) 和应变 (SR) 与 E/e' 比值在无症状系统性高血压患者人群中的关系。

方法：回顾性纳入210例原发性高血压患者。动态图像分析左心室心肌收缩全局纵向应变 (GLS)、左心室纵向峰值收缩应变率 (SRs)、早期舒张峰值应变率 (SRe)、晚期舒张峰值应变率 (SRa)。根据2012年基线E/e'比值，将人群分为三组，A组（E/e'<8）、B组（8≤E/e'≤14）、C组（E/e'<8） '>14)。

结果: 收缩功能参数左心室射血分数 (LVEF) 保持在正常范围内，没有变化，但 E/e' 比值升高的患者 GLS 显着降低，早期舒张应变率 (SRe) 降低，早期舒张应变率比值降低舒张末期应变率 (SRe/a) 和更高的 E/SRe。在 GLS、E/SRe 和 E/e' 比率之间观察到正相关，在 SRe、SRe/a 和 E/e' 比率之间观察到负相关。E/SRe >0.73 的敏感性为 87.7%，特异性为 38.2%，用于预测 E/e' 比值升高 (E/e'>14)。在多变量分析中，IVS-e' <7 cm/s 显示 GLS 降低的风险几乎增加了 2.5 倍（OR 2.48 [95% CI 1.36–4.53]；p = 003）。

结论：我们目前的研究表明，如散斑成像所检测到的，LVEF 保持不变且 E/e' 比值升高的高血压患者在纵向方向上存在收缩和舒张异常。E/SRe 与 E/e' 和预测的左心室充盈压升高密切相关。