الفهرس 
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Abstract
Hypertension disrupts the endothelial lining of cardiovascular system, which increases the risk of the development of atherosclerotic disease. Left ventricular global longitudinal strain (LV GLS) is probably the most frequent type of strain used to assess LV systolic function in clinical practice. The possible mechanism of longitudinal dysfunction in hypertensive patients might be associated with the microcirculatory disturbances, interstitial fibrosis, repetitive minute ischemic events in the sub-endocardium of the left ventricle, resulting in a reduction of longitudinal myocardial contraction force. Non-invasive evaluation of left ventricular systolic function by echocardiography remains one of the most pivotal measures in clinical cardiology.
LV ejection fraction (LVEF) is subject to a number of limitations. For example, it can be normal in the presence of impaired LV systolic function, since it does not reflect intrinsic myocardial contractility. In addition, LVEF is highly load-dependent and suffers from significant intraobserver and interobserver variability. 2D-Speckle tracking echocardiography (2D-STE) permits assessment of the myocardial systolic strain. However, a good imaging quality and high specialized expertise are required for most of the modern echocardiographic techniques for reasonable interpretation of LV systolic function.
In this prospective case control study, we examined 56 hypertensive patients, compared to 28 age-and sex-matched healthy subjects as a control group, referred to Menoufia University Hospitals΄ clinics and echocardiography laboratory, and evaluated in the period from June 2021 to August 2022, regarding their demographics,clinical data, conventional echocardiography (2D, M-mode linear meaurements, Doppler studies) and 2D-STE. M-mode apical systolic excursion (MMASE) was derived by subtracting the distance between the apical line in M-mode in end-diastole and in end-systole, with the left ventricle centered in the scanning sector and the M-mode cursor positioned through the apex, these distances should be recorded in apical 4-chamber view.