The Association Between Presystolic Wave and Subclinical Left Ventricular Dysfunction in Asymptomatic Hypertensive Patients: Speckle-Tracking Echocardiographic Study

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: The Association Between Presystolic Wave and Subclinical Left Ventricular Dysfunction in Asymptomatic Hypertensive Patients

Abstract

Background

Presystolic waves are often found during Doppler evaluation of the left ventricular outflow tract (LVOT) in hypertensive individuals. LV stiffness and altered LV compliance are potential mechanisms for presystolic waves.

Objectives

This study's objective was to examine the relationship between presystolic wave and subclinical left ventricular (LV) impairment in asymptomatic individuals with essential hypertension.

Methods

This observational research comprised 87 individuals with essential hypertension. All patients had two-dimensional and Doppler echocardiography performed. Based on the existence or absence of a presystolic wave, patients were separated into two groups. Using speckle-tracking echocardiography, subclinical LV systolic impairment was identified. Data were analyzed using IBM SPSS version 20.0. The significance level adopted in the statistical analysis was 5%.

Results

The mean age of the studied patients was 51 ± 9 years, with a male percentage of 57.4%. Among them, 57 patients (65%) had a presystolic wave, and 30 (35%) did not. Left ventricular mass index (LVMI) was greater in patients with a presystolic wave in comparison with patients without it (105.8 ± 16.1 g/m² versus 99.8 ± 9.47 g/m², p-value = 0.03). Left atrial volume index (LAVI) was higher in patients with a presystolic wave in comparison with patients without it (28.9 ± 5.25 ml/m² versus 26.3 ± 2.74 ml/m^2, p-value = 0.016). Patients with presystolic wave demonstrated LV diastolic dysfunction more than patients without it (p-value = 0.024). Left ventricular global longitudinal strain (LVGLS) was lower in patients with a presystolic wave in comparison with patients without it (-20.2 ± 2.55 versus -21.7 ± 2.27 % with p-value = 0.008). Patients with presystolic wave demonstrated more subclinical LV systolic dysfunction than patients without it (p-value = 0.025).

Conclusion

The presystolic wave was linked to subclinical LV impairment. The existence of a presystolic wave may indicate hypertensive people who are at risk of developing overt heart failure.

Essential Hypertension; Vascular Stiffness; Echocardiography