Abstract

Objective: To investigate whether myocardial fibrosis assessed non-invasively is related to left ventricular (LV) longitudinal systolic function in patients with essential hypertension.

Design: The study consisted of 30 control subjects and 40 patients with hypertension with normal LV ejection fraction. Tissue Doppler echocardiography was performed to assess LV longitudinal systolic strain from the apical views. Mean strain was calculated from the basal and mid segments. Plasma concentrations of the amino-terminal propeptide of type III procollagen (PIIINP) were measured.

Results: In the hypertension group, mean strain was significantly reduced (mean (SD) 13 (6)% v 21 (6)%, p < 0.01) and plasma PIIINP were increased compared with controls (3.0 (0.7) μg/l v 2.1 (0.3) μg/l, p < 0.001). A significant correlation was found between mean strain and PIIINP (r  =  −0.56, p < 0.001). In patients with abnormal diastolic filling (n  =  21) mean strain was reduced compared with patients with normal LV filling (n  =  19) (10 (6)% v 15 (6)%, p < 0.01) and the serological marker PIIINP was increased (3.5 (0.6) μg/l v 2.5 (0.5) μg/l, p < 0.001).

Conclusions: There is a significant association between the extent of myocardial fibrosis and reduced LV longitudinal contractility.