부산대학교 도서관

OBJECTIVE:: We aimed to examine the predictive value of longitudinal and circumferential strain on adverse cardiovascular (CV) outcome in the hypertensive patients during 5 years of follow-up. DESIGN AND METHOD:: This investigation included 190 untreated hypertensive patients who were recruited for this study in the period between 2011 and 2013. All participants underwent laboratory analysis, 24-h BP monitoring and comprehensive echocardiographic examination at baseline. The patients were followed for at least 5 years (70 ± 8 months) and follow-up data were collected for 177 participants. The adverse outcome was defined as the hospitalization due to CV disease (stroke, arrhythmias, myocardial infarction, heart failure) or CV death. RESULTS:: Adverse CV events were observed in 27 (15%) hypertensive patients during follow-up period. Cox regression analysis showed that reduced left ventricular (LV) longitudinal strain (<|-16.5%|) was associated with the increased risk of adverse events (hazard ration (HR) 2.56, 95% confidence interval (CI): 1.23–7.09, p = 0.009) independently of age, sex, BMI, 24-h systolic blood pressure and LV mass index. Reduced LV circumferential strain (<|-20.0%|) was also associated with increased risk of adverse events (HR 2.11, 95%CI: 1.09–8.46, p = 0.031) independently of aforementioned demographic and clinical parameters. Reduced LV radial strain (<37.5%) did not have predictive value of adverse events during 5-year follow-up period (HR 1.52, 95%CI: 0.83–6.69, p = 0.092). Reduced LV twist was associated with adverse events, but its predictive value vanished after adjustment for other demographic and clinical parameters. CONCLUSIONS:: Left ventricular longitudinal and circumferential strains represent the important predictors of CV adverse events in the hypertensive patients. LV mechanics is useful prognostic tool in recently diagnosed hypertensive patients and its determination should be incorporated in the initial echocardiographic examination.