Abstract 17068: Ventricular Strain is Abnormal in Children With Hypertension
Background: Left ventricular hypertrophy (LVH) is an established marker of end- organ damage in children with hypertension. Abnormal diastolic function and peak systolic strain may precede the development of LVH in children with hypertension.
Objective: To determine the association between LVH, diastolic function and peak systolic strain among children with hypertension.
Methods: 50 hypertensive children aged 3-18 yrs were evaluated by echocardiography. LVH was considered present when left ventricular mass index [LVMI] by M-mode was >95th percentile. Left ventricular diastolic function parameters, including mitral valve inflow (E, A, deceleration time) and septal tissue Doppler (E’, A’), were assessed based on normal values for children. Global peak systolic strain, longitudinal and circumferential, was measured by 2D speckle tracking from apical 4-chamber and parasternal short axis views, respectively. Abnormal strain was defined as <5th percentile. Students t-tests and chi-squared analyses were used to determine associations. P-value <0.05 was considered significant.
Results: 21 (42%) patients had LVH. 10 (20%) had abnormal diastolic function (as measured by E/E’). There was no association between LVH and any diastolic function parameters. Longitudinal and circumferential strain was abnormal in 82% (32/39) and 87% (27/31) of children, respectively. Children with (vs. without) LVH had significantly different mean circumferential strain (-13.8 vs -16.5%; p=0.03); the same association was not found for longitudinal strain (-18.3 vs -17.7%; p=0.44) (FIG).
Conclusion: Among hypertensive children, prevalence of abnormal diastolic function was low yet present in children with and without LVH. While 82% of hypertensive children had abnormal longitudinal strain, only circumferential strain was significantly lower in hypertensive children with ventricular hypertrophy.
- © 2013 by American Heart Association, Inc.