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Hypertension. 2017 Dec;70(6):1142-1147. doi: 10.1161/HYPERTENSIONAHA.117.09574. Epub 2017 Oct 30.

Myocardial Deformation Measured by 3-Dimensional Speckle Tracking in Children and Adolescents With Systemic Arterial Hypertension.

Author information

1
From the Department of Congenital Heart Disease (S.N., H.B.-R., H.C., J.M.S.) and Department of Pediatric Nephrology (H.G., M.D.S.), Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom; and Department of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (H.C., J.M.S.).
2
From the Department of Congenital Heart Disease (S.N., H.B.-R., H.C., J.M.S.) and Department of Pediatric Nephrology (H.G., M.D.S.), Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom; and Department of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (H.C., J.M.S.). john.simpson@gstt.nhs.uk.

Abstract

Systemic arterial hypertension predisposes children to cardiovascular risk in childhood and adult life. Despite extensive study of left ventricular (LV) hypertrophy, detailed 3-dimensional strain analysis of cardiac function in hypertensive children has not been reported. The aim of this study was to evaluate LV mechanics (strain, twist, and torsion) in young patients with hypertension compared with a healthy control group and assess factors associated with functional measurements. Sixty-three patients (26 hypertension and 37 normotensive) were enrolled (mean age, 14.3 and 11.4 years; 54% men and 41% men, respectively). All children underwent clinical evaluation and echocardiographic examination, including 3-dimensional strain. There was no difference in LV volumes and ejection fraction between the groups. Myocardial deformation was significantly reduced in those with hypertension compared with controls. For hypertensive and normotensive groups, respectively, global longitudinal strain was -15.1±2.3 versus -18.5±1.9 (P<0.0001), global circumferential strain -15.2±3 versus -19.9±3.1 (<0.0001), global radial strain +44.0±11.3 versus 63.4±10.5 (P<0.0001), and global 3-dimensional strain -26.1±3.8 versus -31.5±3.8 (P<0.0001). Basal clockwise rotation, apical counterclockwise rotation, twist, and torsion were not significantly different. After multivariate regression analyses blood pressure, body mass index and LV mass maintained a significant relationship with measures of LV strain. Similar ventricular volumes and ejection fraction were observed in hypertensive and normotensive children, but children with hypertension had significantly lower strain indices. Whether reduced strain might predict future cardiovascular risk merits further longitudinal study.

KEYWORDS:

adult; body mass index; child; echocardiography; risk factors; ventricular function, left

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