Speckle tracking echocardiography and tissue Doppler imaging reveal beneficial effect of pharmacotherapy in hypertensives with asymptomatic left ventricular dysfunction

Global longitudinal strain (GLS), assessed by speckle tracking echocardiography, is a sensitive marker of myocardial systolic function and an independent predictor of cardiovascular outcomes. The aim of this study was to investigate the effect of hypotensive treatment on GLS and evaluate the relation between change in GLS and left ventricular (LV) diastolic function. In a group of 125 hypertensive subjects, without any symptoms of heart failure, the detailed echocardiographic assessment of LV systolic and diastolic function was performed before and after 12 months of hypotensive treatment.The mean GLS improved from −18.1 ± 2.6% to −19.3 ± 2.3% (P = .004). Positive change was also observed within parameters of LV diastolic function (E/A: 1.05 ± 0.32 vs. 1.15 ± 0.34; P = .008; e': 9.54 ± 2.60 cm/s vs. 10.59 ± 2.39 cm/s; P = .003; E/e': 7.35 ± 1.85 vs. 6.69 ± 1.61; P = .044). The greatest benefit from hypotensive treatment was noticed within the patients with the lowest baseline absolute values of GLS. The significant correlations between change in GLS and e' (r = −0.51; P < .001) as well as GLS and E/e' ratio (0.23; P = .022) were also observed. Mild systolic and diastolic LV alterations are interdependent and partially reversible. The effects of hypotensive therapy are differentiated in particular individuals, and those with more impaired LV function seem to benefit most.