الفهرس 
The effect of Hypertension and Diabetes on the Left VentricleOnly 14 pages are availabe for public view
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Abstract
Hypertension and diabetes are major contributors to many structural changes, including myocardial fibrosis and progressive alteration of LV systolic & diastolic functions over time. Diabetes itself is an independent risk factor for impaired LV functions, regardless of its association with hypertension or not.
Subclinical deformation of LV systolic function has been demonstrated in hypertensive patients, diabetic patients, and hypertensive-diabetic patients despite their normal EF. Nevertheless, conventional echocardiography remains unable to detect such subtle changes at an early stage, and is only able to detect LV systolic impairment as the disease advances and progresses.
TDI, though very helpful and widely used clinically in detection of diastolic function impairment, is angle-dependent and only provides information in the long axis direction.
2D-STE being an angle-independent technique overcomes the limitations of TDI and allows more accurate assessment of myocardial deformation through its strain and strain rate measurements.
Accordingly, early detection of the preclinical changes in hypertensive & diabetic patients is definitely a crucial clinical routine that would justify the need for more aggressive treatment for such patients, as an attempt to reduce their risk for cardiovascular events.
This study was built with the purpose of evaluating LV function, both systolic and diastolic, in hypertensive patients, diabetic patients, and patients with both hypertension & diabetes, using 2D-STE based longitudinal strain and strain rate imaging measurements, and correlate them with BNP level, which is a marker of LV dysfunction.
80 people were recruited for this purpose, assembled as four separate groups; group 1 (control group): which included 20 normotensive nondiabetic healthy, age and sex matched individuals, free from cardiovascular risk factors. group 2: included 20 hypertensive non-diabetic patients. group 3: included 20 diabetic non-hypertensive patients. And group 4: which included 20 hypertensive diabetic patients.
Full history was taken from all the enrolled subjects, followed by thorough clinical examination and a 12-lead ECG. A blood sample was withdrawn from each participant, and all samples were collected and analyzed using ELISA kit to measure BNP levels.
Echocardiographic examination was performed; including 2D, M-mode, pulsed wave & continuous wave Doppler examination. Cardiac chamber dimensions including LA, AO, LVEDD, LVESD, IVSd, LVPWd and LVEF were measured.
Mitral inflow velocities were also measured by pulsed-wave Doppler and mitral annular peak velocities were measured by TDI. Finally, 2D-STE was performed; strain & strain values were measured after the offline analysis was done for the obtained images.