The impact of systemic hypertension-related heart remodeling on right ventricle mechanics: A two-dimensional echocardiographic speckle tracking study

Abstract

In spite of heart remodeling such as left ventricular hypertrophy (LVH) affects both left and right ventricles due to ventricular interdependence; still, a few studies had examined the outcomes of these effects on right ventricle (RV) and usually focusing on the left ventricle (LV). This study was aimed to evaluate the effect of systemic arterial hypertension (SAM) on RV mechanics using two-dimensional RV longitudinal strains. A case-control study was conducted during the period from July 2016 to April 2018 at Ibn Al-Bytar cardiac center Baghdad, Iraq. One hundred (61 males and 39 female) Patients with SAH were compared with one hundred (57 males and 43 female) healthy control subjects aged from (40-60) years. These groups were subjected to a detailed history, blood pressure measurement, ECG, anthropometry measurements, a list of investigations, and echocardiographic study. The results revealed that the thickness of interventricular septum at diastole (IVSd) was (11.13±1.46) mm in the hypertensive group and was (9.42±0.68) mm in the control group P-value < 0.001. Relative wall thickness (RWT)was (4.65 ±0.28) mm in the patient group and was (3.86 ± 0.34) mm in the control group and P value = 0.01. The mean right ventricular global longitudinal strain (RVGLS) was (- 20.12 ± 3.80) % in a patient group versus (- 25.90 ± 2.18) in the control group, the P value was 0. 001.IVSd significantly correlated with impaired RVGLS in multivariate logistic regression and P value was 0.001, and the odds ratio was 2.418. RV longitudinal strain is significantly impaired in hypertensive patients group and strongly correlates with heart remodeling.