Concentric left ventricular hypertrophy brings deterioration of systolic longitudinal, circumferential, and radial myocardial deformation in hypertensive patients with preserved left ventricular pump function

Background: We hypothesized that deterioration of systolic left ventricular (W) myocardial deformation exists as an early sign of "isolated" diastolic heart failure in patients with hypertension (FIT) and LV hypertrophy (LVH). Methods and results: Two-dimensional strain echocardiography was performed in 98 patients with HT and 22 age-matched normal controls. The LV mass index and relative watt thickness were used to assign patients into 3 groups with normal geometry (N-LV, n=31), concentric hypertrophy (C-LVH, n=25), and eccentric hypertrophy (E-LVH, n=42). The LV ejection fraction was preserved (>= 50%) in the 3 FIT groups. The mean peak systolic longitudinal, circumferential, and radial strains in the C-LVH group were tower compared to the control and other 2 HT groups. The mean peak systolic strain rates in the 3 directions in the C-LVH group and those in the longitudinal and radial directions in the E-LVH and N-LV groups were tower compared to the control group. In addition, the mean peak systolic circumferential strain rate was lower in the C-LVH group than in the other 2 HT groups. There were no differences in the LV torsion and torsional rate between the control and 3 HT groups. The mean peak systolic circumferential strain was an independent predictor related to W ejection fraction in all patients. Conclusions: C-LVH caused deterioration of the systolic longitudinal, circumferential, and radial myocardial deformation in patients with HT W torsion and circumferential shortening were considered to be compensatory mechanisms for maintaining W pump function. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.