Correlation of left ventricular longitudinal strain and E/e’ ratio in primary hypertension patients

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.

KEYWORDS:

• Hypertension
• left ventricular longitudinal strain
• preserved left ventricular ejection fraction
• E/e’ ratio

Acknowledgments

The authors thank all the participants for their efforts and contributions.

Disclosure statement

The authors declare that they have no conflict of interest.

Grant support

This work was supported by the Natural Science Foundation of Guangdong Province (No. 2015A030313660), the Science and Technology Program of Guangzhou (No.201604020143, No.201604020018, No.201510010254, No.201803030012),the Medical Science and Technology Research Fund of Guangdong Province (No.B2018023), the National Key Research and Development Program of China (No.2017FYC1307603,No.2016YFC1301305) and the Science and Technology Program of Guangdong Province (No.2014B020212008).