Left Ventricular Hypertrophy Causes Different Changes in Longitudinal, Radial, and Circumferential Mechanics in Patients with Hypertension: A Two-Dimensional Speckle Tracking Study

Background: Systolic reserve is an important compensatory mechanism against increasing afterload. Although longitudinal systolic dysfunction with preserved ejection fraction has been reported in hypertensive hearts, radial and circumferential function has not been fully examined. The aim of this study was to investigate three-directional systolic function and its relationships with left ventricular geometry in asymptomatic hypertensive patients using two-dimensional speckle-tracking imaging. Methods: Echocardiographic evaluations were performed in 74 hypertensive patients and 55 age-matched control subjects. Results: Longitudinal strain was significantly reduced in the hypertrophy groups compared with that in control subjects (concentric, -15.1 +/- 4.0%; eccentric, -15.9 +/- 4.4%; control, -18.9 +/- 3.3%; P < .05). Conversely, radial strain was significantly higher in the normal geometry group than in control subjects (53.8 +/- 19.4% vs 40.3 +/- 15.1%, P < .05). However, this augmentation was attenuated in the other geometries. Conclusion: Hypertrophic remodeling attenuates compensatory augmentation of radial systolic function and is associated with latent longitudinal systolic dysfunction. (J Am Soc Echocardiogr 2011; 24: 192-9.)