Clinical value of non-invasive pressure-strain loop in assessing left ventricular myocardial work in patients with primary hypertension / 中华健康管理学杂志

ABSTRACT

Objective:To analyze the clinical value of noninvasive pressure strain loop (PSL) in assessing left ventricular myocardial work in patients with essential hypertension.Methods:In this cross-sectional study, 66 patients with essential hypertension who were admitted to the Affiliated Hospital of Yangzhou University from August to December 2020 were continuously enrolled. According to left ventricular mass index (LVMI) >95 g/m 2 in women and >115 g/m 2 in men,≤95 g/m 2 in women and ≤115 g/m 2 in men, the 66 patients were divided into left ventricular hypertrophy (LVH) group (14 cases) and non-left ventricular hypertrophy (NLVH) group (52 cases). Furthermore, the NLVH group was divided into a mild group (30 cases) and a moderate/severe group (22 cases) according to the systolic blood pressure of 140~159 mmHg (1 mmHg=0.133 kPa) and ≥160 mmHg. Another 25 healthy adults who underwent physical examination during the same period were included as healthy control group. The height, weight and blood pressure were measured in all the subjects, and routine echocardiography and speckle tracking imaging analysis were performed. PSL results were obtained by combining the results of speckle tracking imaging analysis with systolic blood pressure. The differences of general clinical data, basic parameters of two-dimensional ultrasound and myocardial work parameters of PSL (global work index, global effective work, global wasted work, and global work efficiency) were compared among the groups, and the clinical value of PSL in assessing left ventricular myocardial work in patients with essential hypertension was analyzed. Results:There was no significant difference in left ventricular ejection fraction among all groups (all P>0.05). The global work index of moderate/severe NLVH group was significantly higher than that of mild NLVH group, LVH group and healthy control group [(2 630±231) vs (2 254±179), (1 847±261), (1 724±209) mmHg%]. The global effective work of moderate/severe NLVH group was significantly higher than that of LVH group and healthy control group [(2 965±261) vs (2 330±258) and (2 121±163) mmHg%] (all P<0.05). The global wasted work of LVH group was significantly higher than that of moderate/severe NLVH group, mild NLVH group and healthy control group [(248±107) vs (141±57), (116±57), (83±58) mmHg%] (all P<0.05). The global work efficiency was significantly lower than that of moderate/severe NLVH group, mild NLVH group and healthy control group (89.1%±3.9% vs 94.3%±1.9%, 95.0%±1.8%, 95.8%±2.3%) (all P<0.05). With the increase of blood pressure, the PSL decreased in the LVH group and increased in the other three groups. The bull′s eye diagram of myocardial work in the healthy control group was uniform green (normal effective work area), red began to appear in the mild NLVH group (high intensity myocardial work area), red area increased in the moderate/severe NLVH group, and blue appeared in the LVH group (ineffective work area). Conclusions:PSL has good clinical value in assessing left ventricular myocardial work in patients with primary hypertension. The parameters derived from PSL data can sensitively identify impaired systolic function in individuals with normal left ventricular ejection fraction.