Improvement in Left Ventricular Systolic Dyssynchrony in Hypertensive Patients After Treatment of Hypertension

Background and Objectives: Left ventricular (LV) dyssynchrony has been commonly detected among hypertensive patients with normal LV systolic function and no evidence of congestive heart failure. The purpose of our study was to assess the changes in LV systolic dyssynchrony ($SDS_{LV}$) among hypertensive patients after antihypertensive treatment, and to determine the relationship between $SDS_{LV}$ and other conventional echocardiographic parameters. Subjects and Methods: Forty one hypertensive patients with normal LV ejection fraction were enrolled. By performing a conventional echocardiographic study, the $SDS_{LV}$ was measured as the time difference between the shortest and longest time of the peak myocardial systolic velocities among 12 segments of the basal and mid-levels of the 3 apical views, and radial dyssynchrony of the basal ($RDS_{base}$) and mid-levels ($RDS_{mid}$) measured as the time difference between the earliest and latest peak values on the radial strain curves of each level of the parasternal short-axis views. Results: Compared to baseline after six months of antihypertensive treatment, the $SDS_{LV}$ improved significantly (48.7${\pm}$37.9 ms vs. 29.5${\pm}$34.1 ms, p=0.020). Also the $RDS_{base}$ and $RDS_{mid}$ improved significantly in respect to the baseline values (129.9${\pm}$136.3 ms vs. 38.8${\pm}$45.4 ms, p=0.002 and 75.2${\pm}$63.8 ms vs. 28.2${\pm}$37.7 ms, respectively, p<0.001). Conclusion: The severity of $SDS_{LV}$ improved with antihypertensive treatment, and was associated with the regression of LV mass. Furthermore, it might precede improvement in the mitral inflow pattern, as assessed by conventional echocardiography, so that early detection of the benefit of antihypertensive treatment may be possible.