To explore the characteristic of three-dimensional strain speckle tracking imaging (3D-STI) of left ventricular (LV) systolic function in patients with primary hypertension (HT), and to observe the value of three-dimensional strain imaging in early diagnosis of hypertension induced myocardial dysfunction.

From September 2013 to January 2015, 79 patients with primary hypertension diagnosed in Beijing Army General Hospital were divided into two groups: group left ventricular normal geometry (LVN, n=42), and group left ventricular hypertrophy (LVH, n=37). Concurrently, 30 age-matched healthy subjects were enrolled as the controls. Parameters of LV and values of left ventricle ejection fraction (LVEF) and left ventricular mass (LVM) were acquired by three-dimensional full volume echocardiography. Left ventricular mass index (LVMI) was calculated. Left ventricle global longitudinal strain (LVGLS), left ventricle global radial strain (LVGRS), left ventricle global circular strain (LVGCS), and left ventricle global area strain (LVGAS) were analyzed off line using three-dimensional strain imaging, respectively. The global strain (LVGLS, LVGRS, LVGCS and LVGAS, respectively) and mean values of all segments were acquired. All data of 3 groups were analyzed using One-Way analysis of variance, and LSD-t test was used to compare between two groups. The correlation between LVGLS and LVMI and the correlation between LVGAS and LVMI in hypertensive patients was tested by Pearson correlation analysis.

There were significant differences of LVMI among the 3 groups (88.5±10.2, 102.4±13.5 and 128.0±17.2). LVMI were significantly increased in the LVN and LVH groups compared with those in control group. LVMI in group LVH was significantly higher than that in group LVN (t=22.152, 39.623 and 31.125, all P<0. 05). The value of LVGLS, LVGRS, LCGCS and LVGAS were (-22.2±5.8)%, (-17.6±5.2)%, (-13.7±4.5)%, (41.6±7.5)%, (38.8±8.6)%, (30.1±7.4)%, (-20.9±6.6)%, (-19.6±5.4)%, (-12.4±5.5)%, (-33.2±6.9)%, (-26.6±6.4)% and (-20.2±5.6)% in group control, group LVN and group LVH, respectively. LVGLS and LVGAS were significantly decreased in the LVN and LVH group compared with those in control group, and the LVGLS and LVGAS in group LVH were significantly lower than those in group LVN (LVGLS: t=8.642, 22.623 and 13.125; LVGAS: t=12.591, 30.332 and 21.302; all P<0.05). There was no significant difference of LVGRS and LVGCS between group LVN and control group (t=0.386 and 0.599, both P>0. 05). The parameters of LVGRS and LVGCS in LVH group were lower than those in control group and LVN group (LVGRS: t=16.605 and 9.613; LVGCS: t=10.130 and 9.526; all P<0.05). Pearson correlation analysis indicated that decreased LVGLS and LVGAS in patients with hypertension were inversely linearly correlated with increasing LVMI (r=-0.728 and -0.853, both P<0. 05).

Three-dimensional STI can evaluate the early change of left ventricular systolic dysfunctions in hypertensive patients, can detect the decreases of LV myocardial three-dimensional strain with the LVH.