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Contemporary approaches to early detection of asymptomatic heart disease in patients with hypertension
- Authors: Kuchmin A.N.1, Galova E.P.1, Sveklina T.S.1, Nagorny M.B.1, Filvarkovyi A.N.1, Shevelev A.A.1
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Affiliations:
- Kirov Military Medical Academy
- Issue: Vol 27, No 4 (2025)
- Pages: 485-492
- Section: Original Study Article
- URL: https://medbiosci.ru/1682-7392/article/view/363037
- DOI: https://doi.org/10.17816/brmma660883
- EDN: https://elibrary.ru/SYUXQK
- ID: 363037
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Abstract
BACKGROUND: The onset and progression of hypertension may damage target organs, particularly the heart. This disease is asymptomatic during its early stages. According to Russian guidelines for the treatment of hypertension, left ventricular myocardial hypertrophy is the primary marker of asymptomatic heart disease. Earlier signs may include functional changes in the left atrium, which is detected by speckle tracking echocardiography with longitudinal strain assessment.
AIM: This study aimed to assess the efficacy of speckle tracking echocardiography with longitudinal strain assessment in detecting early signs of left myocardial dysfunction in patients with hypertension.
METHODS: Segmental and global left atrial and ventricular longitudinal strain was evaluated in patients with hypertension with or without left ventricular hypertrophy and a control group. The longitudinal strain was assessed by analyzing curves of segmental longitudinal strain peaks and rates. Following echocardiography in three standard apical views, software was used to convert data into bull’s eye diagrams. This enabled a comprehensive assessment of global and regional left ventricular contractility using numeric and color parameters. Segmental left ventricular and left atrial longitudinal strain was evaluated using 17 and 6 segments, respectively.
RESULTS: No significant differences were found in global left ventricular longitudinal strain parameters between patients with hypertension without echocardiographic signs of left ventricular hypertrophy and healthy individuals. Patients with hypertension (both with and without left ventricular hypertrophy) showed a significant decrease in left atrial longitudinal strain compared to healthy individuals.
CONCLUSION: Decreased left atrial longitudinal strain may be the earliest sign of asymptomatic heart disease in hypertension. Impaired longitudinal strain in the left ventricular basal segments is associated with left ventricular hypertrophy in patients with hypertension.
About the authors
Alexey N. Kuchmin
Kirov Military Medical Academy
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0003-2888-9625
SPIN-code: 7787-1364
MD, Dr. Sci. (Medicine), Professor
Russian Federation, Saint PetersburgElena P. Galova
Kirov Military Medical Academy
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0001-7820-0481
SPIN-code: 7306-8096
Doctor of functional diagnostics
Russian Federation, Saint PetersburgTatiana S. Sveklina
Kirov Military Medical Academy
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0001-9546-7049
SPIN-code: 3561-6503
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgMikhail B. Nagorny
Kirov Military Medical Academy
Author for correspondence.
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-5542-0948
SPIN-code: 1861-8100
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgAndrey N. Filvarkovyi
Kirov Military Medical Academy
Email: vmeda-nio@mil.ru
ORCID iD: 0009-0004-0930-9693
therapist
Russian Federation, Saint PetersburgAndrey A. Shevelev
Kirov Military Medical Academy
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-6986-8655
SPIN-code: 5766-8003
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgReferences
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