Assessment Of Left Ventricular Twist And Untwist In Patients With Essential Hypertension Using Speckle Tracking Imaging Echocardigraphy

ObjectiveTo assess the left ventricular (LV) twist and untwist changes in patients with primary hypertension using speckle tracking imaging (STI) echocardiography, also to assess the LV twist and untwist changes in patients with different degrees of left ventricular hypertrophy (LVH) furtherly.Methods45 primary hypertension patiens groupeded into 3 groups accroding to different degrees of LVH were included and 20 healthy subjects were on control group. Clear two-dimensional images of the left ventricular short axis views at basal and apical levels were recorded in 4 continuous cardiac cycles. The images were analyzed by 2D-speckle tracking soft in Echo PAC workstation, we acquired rotation angle-time and rotation velocity-time curves of the above two planes and global LV twist angle-time and twist velocity-time curves.Results1. Untwisting early in diastole and untwisting rate were significantly reduced in parallel to increasing left ventricular mass index (LVMI) (P<0.01). The duration of normalized time-to-peak untwisting velocity (TPUV) was significantly prolonged (P< 0.01) and peak untwisting velocity (PUV) increased (P<0.05).2. The peak systolic twist increased in hypertensive patients, but no inter-group differences were noted among patients with different degrees of LVH (P>0.05).The LV twist angle-time and twist velocity-time curves in hypertensive patients performs a similar courser tendency with healthy subjects.3. The novel diastolic parameters derivatized from STI (including untwisting or untwisting rates during early diastole, standardized TPUV) were more sensitive than traditional diastolic parameters in reflexing changes of LV relaxation fuction during early diastole.ConclusionsnsThe reduced and delayed diastolic untwisting during the isovolumic relaxation period noted in essential hypertensive patients may contribute to the LV relaxation reduced. Speckle tracking imaging echocardiography is a novel tool which can be used for the non-invasive and quantitateive assessment of LV relaxation.