Background: Hypertension and diabetes are major contributors to structural changes including myocardial fibrosis and progressive alteration of LV systolic and diastolic functions. Two-dimensional speckle tracking echocardiography is a reliable imaging modality that overcomes the limitations of Tissue Doppler imaging and allows a more accurate assessment of myocardial deformation at the global and regional levels. Objectives: The investigation aims to assess Left Ventricular functions in patients with hypertension and/or diabetes who have apparently preserved LV systolic function; using speckle tracking echocardiography, and correlate the findings with plasma Brain Natriuretic Peptide levels. Methods: Twenty healthy subjects were enrolled as a control group. Sixty patients with hypertension and/or diabetes were recruited and assembled as three equal groups, hypertensives, diabetics, and hypertensive-diabetics. 2D-STE was performed to assess LV longitudinal strain and strain rate. Plasma BNP levels were measured for all subjects. Results: Global systolic longitudinal strain was significantly reduced in patients compared to controls (P=0.001). It was more reduced in group 4. Global systolic SR was reduced in patients compared to controls, being more significantly reduced in groups 2 and 4 (P=0.001). Global early diastolic SR was reduced in patients compared to controls (P=0.001). Meanwhile, Global late diastolic SR values were higher among patients, especially groups 2 and 4 (P=0.001). BNP levels were significantly higher in group 4 compared to group 1 (P=0.000), group 2 (P=0.000), and group 3 (P=0.000). BNP levels and global systolic strain in group 4 were significantly correlated. Conclusion: LV systolic dysfunction was found among all patients groups, confirmed by the significant reduction in LV global longitudinal systolic SR. Hypertensive-diabetics exhibited lower global strain than patients with hypertension only and patients with diabetes only, even though their EF showed no apparent difference. Elevated BNP levels, being the highest among group 4, indicate the presence of ventricular dysfunction, even before chamber failure occurs.
| Published in | Cardiology and Cardiovascular Research (Volume 4, Issue 3) |
| DOI | 10.11648/j.ccr.20200403.19 |
| Page(s) | 131-145 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Hypertension, Diabetes, Speckle Tracking Echocardiography, Left Ventricular Functions, Strain, Strain Rate
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APA Style
Mohammed Fahmy El-Noamany, Ashraf Abd ElRaouf Dawood, Waleed Abdou Ibrahim Hamed, Nowrus Emad Amer. (2020). Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels. Cardiology and Cardiovascular Research, 4(3), 131-145. https://doi.org/10.11648/j.ccr.20200403.19
ACS Style
Mohammed Fahmy El-Noamany; Ashraf Abd ElRaouf Dawood; Waleed Abdou Ibrahim Hamed; Nowrus Emad Amer. Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels. Cardiol. Cardiovasc. Res. 2020, 4(3), 131-145. doi: 10.11648/j.ccr.20200403.19
AMA Style
Mohammed Fahmy El-Noamany, Ashraf Abd ElRaouf Dawood, Waleed Abdou Ibrahim Hamed, Nowrus Emad Amer. Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels. Cardiol Cardiovasc Res. 2020;4(3):131-145. doi: 10.11648/j.ccr.20200403.19
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author = {Mohammed Fahmy El-Noamany and Ashraf Abd ElRaouf Dawood and Waleed Abdou Ibrahim Hamed and Nowrus Emad Amer},
title = {Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels},
journal = {Cardiology and Cardiovascular Research},
volume = {4},
number = {3},
pages = {131-145},
doi = {10.11648/j.ccr.20200403.19},
url = {https://doi.org/10.11648/j.ccr.20200403.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200403.19},
abstract = {Background: Hypertension and diabetes are major contributors to structural changes including myocardial fibrosis and progressive alteration of LV systolic and diastolic functions. Two-dimensional speckle tracking echocardiography is a reliable imaging modality that overcomes the limitations of Tissue Doppler imaging and allows a more accurate assessment of myocardial deformation at the global and regional levels. Objectives: The investigation aims to assess Left Ventricular functions in patients with hypertension and/or diabetes who have apparently preserved LV systolic function; using speckle tracking echocardiography, and correlate the findings with plasma Brain Natriuretic Peptide levels. Methods: Twenty healthy subjects were enrolled as a control group. Sixty patients with hypertension and/or diabetes were recruited and assembled as three equal groups, hypertensives, diabetics, and hypertensive-diabetics. 2D-STE was performed to assess LV longitudinal strain and strain rate. Plasma BNP levels were measured for all subjects. Results: Global systolic longitudinal strain was significantly reduced in patients compared to controls (P=0.001). It was more reduced in group 4. Global systolic SR was reduced in patients compared to controls, being more significantly reduced in groups 2 and 4 (P=0.001). Global early diastolic SR was reduced in patients compared to controls (P=0.001). Meanwhile, Global late diastolic SR values were higher among patients, especially groups 2 and 4 (P=0.001). BNP levels were significantly higher in group 4 compared to group 1 (P=0.000), group 2 (P=0.000), and group 3 (P=0.000). BNP levels and global systolic strain in group 4 were significantly correlated. Conclusion: LV systolic dysfunction was found among all patients groups, confirmed by the significant reduction in LV global longitudinal systolic SR. Hypertensive-diabetics exhibited lower global strain than patients with hypertension only and patients with diabetes only, even though their EF showed no apparent difference. Elevated BNP levels, being the highest among group 4, indicate the presence of ventricular dysfunction, even before chamber failure occurs.},
year = {2020}
}
TY - JOUR T1 - Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels AU - Mohammed Fahmy El-Noamany AU - Ashraf Abd ElRaouf Dawood AU - Waleed Abdou Ibrahim Hamed AU - Nowrus Emad Amer Y1 - 2020/08/18 PY - 2020 N1 - https://doi.org/10.11648/j.ccr.20200403.19 DO - 10.11648/j.ccr.20200403.19 T2 - Cardiology and Cardiovascular Research JF - Cardiology and Cardiovascular Research JO - Cardiology and Cardiovascular Research SP - 131 EP - 145 PB - Science Publishing Group SN - 2578-8914 UR - https://doi.org/10.11648/j.ccr.20200403.19 AB - Background: Hypertension and diabetes are major contributors to structural changes including myocardial fibrosis and progressive alteration of LV systolic and diastolic functions. Two-dimensional speckle tracking echocardiography is a reliable imaging modality that overcomes the limitations of Tissue Doppler imaging and allows a more accurate assessment of myocardial deformation at the global and regional levels. Objectives: The investigation aims to assess Left Ventricular functions in patients with hypertension and/or diabetes who have apparently preserved LV systolic function; using speckle tracking echocardiography, and correlate the findings with plasma Brain Natriuretic Peptide levels. Methods: Twenty healthy subjects were enrolled as a control group. Sixty patients with hypertension and/or diabetes were recruited and assembled as three equal groups, hypertensives, diabetics, and hypertensive-diabetics. 2D-STE was performed to assess LV longitudinal strain and strain rate. Plasma BNP levels were measured for all subjects. Results: Global systolic longitudinal strain was significantly reduced in patients compared to controls (P=0.001). It was more reduced in group 4. Global systolic SR was reduced in patients compared to controls, being more significantly reduced in groups 2 and 4 (P=0.001). Global early diastolic SR was reduced in patients compared to controls (P=0.001). Meanwhile, Global late diastolic SR values were higher among patients, especially groups 2 and 4 (P=0.001). BNP levels were significantly higher in group 4 compared to group 1 (P=0.000), group 2 (P=0.000), and group 3 (P=0.000). BNP levels and global systolic strain in group 4 were significantly correlated. Conclusion: LV systolic dysfunction was found among all patients groups, confirmed by the significant reduction in LV global longitudinal systolic SR. Hypertensive-diabetics exhibited lower global strain than patients with hypertension only and patients with diabetes only, even though their EF showed no apparent difference. Elevated BNP levels, being the highest among group 4, indicate the presence of ventricular dysfunction, even before chamber failure occurs. VL - 4 IS - 3 ER -
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