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Echocardiographic assessment of Left Ventricular Dyssynchrony in Hypertensive Patients with Normal Systolic Function

Background: Normal Left Ventricular systolic function is present in nearly 50% of patients with congestive heart failure, the majority of such patients have systemic hypertension. Recent studies have demonstrated Left Ventricular dyssynchrony among patients with heart failure and normal systolic function. The co-existence between Left Ventricular dyssynchrony and hypertension with normal systolic function (with no clinical evidence of heart failure) is less well understood.

Objective:

To assess the Left Ventricular dyssynchrony among hypertensive patients with normal systolic function by using Tissue doppler imaging.To find out the associations between the LV dyssynchrony and other global echocardiographic findings like (LA volume index, LVmassindex , LV sephericity and LV filling pressure E/E`)

Type of the study: Prospective case- control study

 Methods:  The study conducted in Baghdad Teaching Hospital from 1st of June 2015 to 30th of May 2016 .Study included two groups of people, 40 patients, age_ matched healthy (control) group (group1) and 60 patients with established hypertension (group 2). A Complete 2-D and TDI echocardiography studies with simultaneous ECG were performed for all patients. Examination involved LV septal and posterior wall thicknesses, internal dimensions, left atrial size, ejection fraction and tissue doppler derived waves velocities E', E/E.' Dyssynchrony was determined by measuring T-P max ( the maximal time difference from the onset of QRS to peak systolic velocity on TDI between any opposing LV wall in 3 apical views) .

Results: The study included 40 age –matched control people, 27males (67.5%) and 13 females (32.5%) with a male to female ratio was 1.8 :1, ranging from (42.4-58y) with mean age was (50.2 ±7.8y ) (group 1) and 60 hypertensive patients, 38 males (63.3%) and 22 females (36.7%) with a male to female ratio was 1.7 :1, ranging from (48.5- 66.5y) with mean age of (57.5± 9.0 y) (group 2) . Left Ventricular dyssynchrony was identified in 20 of 60 patients (33.3%) .Dyssynchrony had no significant association with age and BSA. But it  was significantly associated with LA volume index (r = 0.61, p=0.001), LV mass index(r=0.52 ,p=0.001) , LV sphericity index (r= 0.5, p = 0.003) ) and LV filling pressure(r=0.6 , p value=0.001) . Dyssynchrony had significant negative correlation with ( E`) velocity (r= - 0.7 ,P =0.001) .

Conclusion: Left Ventricular dyssynchrony is frequent among hypertensive patients with normal LV systolic function .The Left Ventricular dyssynchrony is significantly related to LA volume, LV mass, LV sphericity and LV filling pressure.

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Echocardiographic Assessment of Left Ventricular Function in Overweight and Obese Subjects

Background: Obesity is a public health concern worldwide associated with significant health risks and comorbid conditions. Obesity might be a strong factor that can induce left ventricular systolic dysfunction and eventually cause heart failure independent to coronary artery disease or other morbidities. In uncomplicated obese subjects, diastolic dysfunction is caused by hemodynamic and metabolic factors.
Objectives: To assess the left ventricular (systolic and diastolic) function in a sample of overweight and obese subjects using different Echocardiographic tools and exploring the percentage and type of diastolic dysfunction in those people.
Subjects and methods: one hundred seven (107) normal adult males subjects with a mean age

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Publication Date
Mon Apr 01 2019
Journal Name
World Heart Journal
Echocardiographic Evaluation of the Right Ventricular Function in a Sample of Iraqi Patients with Left Ventricular Dysfunction

Background: Assessment of function of the right side of the heart in cases of left ventricular dysfunction has been widely studied but the sensitive and specific echocardiographic parameter to be tested is still a matter of controversy. Right ventricular function is related to left ventricular function by ventricular independence so function of both should be assessed carefully. The objective of this study was to evaluate the effects of left ventricular systolic dysfunction on right ventricular systolic and diastolic functions and pulmonary pressure using conventional and tissue Doppler echocardiography. Patients and Methods: Sixty patients (39 males and 21 females) with heart failure due to left ventricular systolic dysfunction

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Publication Date
Mon Jul 29 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Role of Two- Dimensional Speckle Tracking Strain versus Conventional Echocardiography in the Assessments of Left Ventricular Systolic Function in Middle-aged Hypertensive Patients.
Background: Global longitudinal strain (GLS) echocardiography is a new technique that can be used to  detect an early left ventricular dysfunction in various heart diseases . Systemic hypertension is a major risk factor for cardiovascular accidents. The early management of its complication on the heart plays  an
important role in the outcome of the disease. Hypertension is associated with changes in several aspects
of left ventricular structure, function, and systolic strains. Various echocardiographic techniques are used to evaluate left ventricular function in hypertensive patient
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Publication Date
Sun Apr 05 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Relation of the Ankle Brachial Index (ABI) to left ventricular systolic function in patients with coronary artery disease

Background: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –Brachial Pressure Index (ABI) is a simple index related to the extent of atherosclerosis in coronary and noncoronary arterial beds, reflecting generalized atherosclerosis.
Objectives: the aim of this study is to evaluate the relation of ABI to left ventricular systolic function using echocardiography in patients with coronary artery disease (CAD).
Patients and Methods: Sixty seven patients (67) with CAD of either sex (70% males) with mean age 58± 6 years enrolled in this study, from December 2013 till May 2014; all were referred to the Iraqi Centre for Heart Disease (I.C.H.D.) for further evalua

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Publication Date
Mon Jan 02 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Echocardiographic assessment of left ventricular diastolic dysfunction in ischemic heart disease.

Background: the most common underlying cause of left ventricular (LV) diastolic dysfunction is myocardial ischemia. Diastolic dysfunction has been reported in up to 90% of patients with coronary artery disease.

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Publication Date
Sun Oct 01 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prognostic Significance Of Left Ventricular Diastolic Dysfunction With Preserved Systolic Function Following Acute Myocardial Infarction

Background : The contribution of diastolic dysfunction in patients with preserved left ventricular (LV) systolic function to impaired functional status and cardiac mortality in myocardial infarction (MI) is unknown.
Materials and Methods : Assessment of LV diastolic function was performed by Doppler analysis of the mitral and pulmonary venous flow and the propagation velocity of early mitral flow by color M-mode Doppler echocardiography in 150 consecutive patients at day 5-7 following their first acute MI.
Results : Patients were classified into four groups: group A: preserved LV systolic and diastolic function (n=59); group B: LV systolic dysfunction with preserved diastolic function (n=8); group C: LV diastolic dysfunction with

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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Cardiology
The role of myocardial performance index in assessment of left ventricular function in patients with valvular mitral regurgitation

Background: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca

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Publication Date
Thu Sep 01 2022
Journal Name
Journal Of Medicine And Life
Arrhythmia related to hypertensive left ventricular hypertrophy in Iraqi patients: frequency and outcome

Left ventricular hypertrophy (LVH) caused by high blood pressure is linked to increased mortality and arrhythmia risk. This study aimed to evaluate arrhythmia in hypertensive patients due to left ventricular hypertrophy (LVH). A cross-sectional study was performed, assessing participants' blood pressure, echocardiography and electrocardiography, and Holter monitoring in certain cases. There were 300 hypertensive patients >18 years attending the cardiology unit of Baghdad medical city. The study was conducted between January–June 2022. The electrocardiograms at rest for 300 adults with hypertension were investigated. 130 (43.5%) were females, and 170 (56.5%) were males. The mean age of participants was 58 years. Forty-nine (16.3

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Publication Date
Sun Jun 09 2019
Journal Name
Al-kindy College Medical Journal
Early Detection of Left Ventricular Systolic Dysfunction in Asymptomatic Patients with Chronic Aortic Regurgitation by two Dimensional Speckle Tracking Echocardiography

Background: Early detection of subclinical left ventricular (LV) systolic dysfunction is crucial and could influence patients' prognosis by aiding the clinician to candidate patients for better management.

Objective: To detect early LV systolic dysfunction in asymptomatic patient with chronic aortic regurgitation by two dimensional speckle tracking echocardiography.

 Methods:  Sixty one asymptomatic patients with chronic aortic regurgitation, with no ischemic heart diseases (by coronary angiography) or conductive heart diseases, no diabetes mellitus, no hypertension, and no other valvular heart diseases (group 1) and fifty age and sex-matched healthy subjects (

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of left ventricular function in diabetics with ischemic heart disease

Background: Diabetes mellitus is a major risk factor for coronary artery disease, with a higher incidence of myocardial infarction and sudden death. Left ventricular dysfunction is difficult to diagnose and to differentiate into diastolic and systolic dysfunction on the basis of medical history, physical examination, electrocardiography (ECC) and chest radiography. Two-dimensional, M-mode, and Doppler echocardiography are excellent for diagnosing left ventricular dysfunction. M-mode echocardiography was used for diagnosing left ventricular systolic dysfunction, while Doppler echocardiography has become well accepted as a reliable, reproducible and practical noninvasive method for the diagnosis of left v

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