Background: Left Ventricular (LV) systolic dyssynchrony is common in patients with hypertension who are susceptible to the development of heart failure. The early detection of systolic dysfunction is thus a valuable information for implementing interventions for prevention of progression of heart failure. Patterns and degree of alterations in mechanical dyssynchrony in different segments of LV and its determinants in hypertensive patients have not been studied well. The present study thus aimed to evaluate the prevalence of LV systolic dyssynchrony in stable, asymptomatic patients with hypertension.

Material and Method: 2–dimensional echocardiographic (2DE) images of the LV were acquired in apical 4–chamber and parasternal short–axis view at mid ventricular levels to assess systolic dyssynchrony in 72 hypertensive patients with normal Left Ventricular Ejection Fraction (LVEF) and 57 healthy controls using speckle tracking method. LV Mass and LVEF were measured using 2D guided M Mode scan and diastolic function was assessed in early diastole with tissue Doppler imaging.

Results:                                  

The QRS complex was significantly prolonged in the hypertensive group as compared to the controls (109.5±20.4 vs 86.5±9.4, P<.01). Also the systolic dyssynchrony indices were significantly higher in patients with hypertension than in the normal controls in between all the segments of the septum and the lateral wall of the LV (P < .01).

Conclusions: Sub clinical Left ventricular dyssynchrony is common among hypertensive patients with normal LV systolic function and no evidence of congestive heart failure.