الفهرس 
Introduction to HypertensionOnly 14 pages are availabe for public view
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Abstract
Hypertension is a major cardiovascular risk, of all known risk factors, hypertension is the most prevalent.
Left ventricular hypertrophy is the most powerful risk factor for coronary heart disease, ventricular arrhythmias, congestive heart failure, and sudden death.
Speckle tracking echocardiography is an angle-independent technique that may allow an accurate assessment of segmental myocardial deformation. Layer-specific strain analysis is a relatively new method that provides endocardial, myocardial, and epicardial layer assessment.
Subclinical deformation of LV systolic function has been demonstrated in hypertensive 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.
LVH with strain is independently associated with all‐cause mortality, adverse cardiovascular events, development of LV concentric remodeling and systolic dysfunction. ECG strain may be an early marker of LV structural remodeling that contributes to development of adverse cardiovascular events.
Accordingly, early detection of the preclinical changes in hypertensive patients is definitely a crucial clinical routine that would justify the need for more aggressive treatment for such patients in an attempt to reduce their risk for cardiovascular events.
(The aim of work):
To assess the effect of HTN on different layers of myocardium using 2D speckle tracking echocardiography in patients with and without LV strain pattern and to assess if hypertensive patients with a strain pattern on ECG have more ischemic changes at the level of the myocardium or if it is just an electrical phenomenon associated with hypertension.
(Methods):
This study was conducted on (100) hypertensive patients who underwent coronary angiography for suspected angina pectoris and reviled normal coronaries and were recruited for the investigation of the effect of HTN on different layers of myocardium using 2D speckle tracking echocardiography and (15) normotensive health volunteers age and sex matched as a control group, the 1st group (G1) including 50 hypertensive patients with strain ST-T changes on ECG mean age at presentation was 52.04 ± 4.55 years, the 2nd group (G2) including 50 hypertensive patients without strain ST-T changes on ECG mean age was 50.20 ± 3.63years and another 3rd control group (G3) including 15 normotensive volunteers mean age was and 51.13 ± 3.54 years.
All patients and control subjects had normal LV ejection fraction (LVEF >50%) and sinus rhythm ECG.
The study population was subjected to complete clinical evaluation, including history and a full physical examination), Standard 12-lead Electrocardiogram (ECG) to detect the presence of strain ST-T changes and exclude rhythm disturbances or ischemic changes, and Transthoracic echocardiography to detect LVH and exclude significant valvular diseases, and speckle tracking was done to assess layered strain.