Left ventricular longitudinal rotation changes in primary hypertension patients with normal left ventricular ejection fraction detected by two-dimensional speckle tracking imaging.

In order to assess the left ventricular (LV) longitudinal rotation (LR) in primary hypertension (PH) patients with a normal LV ejection fraction. Conventional echocardiography was performed in 61 healthy subjects and 64 PH patients. The apical four-chamber views in these patients were acquired by GE-Vivid7 or E9, then the peak radial strain in the systolic period and the strain rate in systole, in early and late diastolic periods, were measured. Segmental LR and global LR were assessed by using two-dimensional speckle tracking imaging (2D-STI). The peak radial strain rate in the early diastolic period in PH patients was significantly lower than that in healthy subjects. The rotational degrees of the middle and base lateral, the apex and the middle septum walls in PH patients were significantly different from those of the healthy subjects. The healthy subjects had prominent counter-clockwise LR (0.29°±2.86°) and the PH patients had prominent clockwise LR (-2.13°±2.93°) in non-LV wall hypertrophy and (-2.43°±2.66°) in LV wall hypertrophy. The time delay between the LV lateral wall and the septum wall in PH patients correlated to the peak LR. We concluded that 2D-STI can assess the time delay between the LV lateral wall and the septum wall to the peak LR and clockwise LR in patients with PH, and prove that PH patients have a clockwise LR. By this, we conclude that in PH patients, the LV early systolic function have changed.