Impact of hypertension and hypertensive left ventricular hypertrophy on left ventricular mechanical dyssynchrony in patients with normal gated-SPECT myocardial perfusion imaging

Introduction: Left ventricular hypertrophy (LVH) represents structural changes of the myocardium in hypertensive patients, which can lead to heart failure. The main aim of this study was to investigate the impact of hypertension and hypertensive LVH on left ventricular mechanical dyssynchrony (LVMD).Methods: This study was conducted on patients without known history of coronary artery disease who were referred by cardiologists for myocardial perfusion imaging (MPI) in ۲۰۲۳ and ۲۰۲۴. The presence or absence of LVH was determined based on the patient's echocardiography. MPI was performed in stress and rest phases by gated-SPECT imaging, and LVMD was determined using QGS software phase analysis.Results: In this study, ۸۴۳ patients were evaluated, including ۵۷۵ women (۶۸.۲۱%) and ۲۶۸ men (۳۱.۷۹%). Four hundred and fifty patients (۵۳.۳۸%) had a history of hypertension, and ۱۵۵ patients (۱۸.۴۵%) had LVH. The prevalence of LVMD in hypertensive patients with LVH (۲۳.۸۷%) was significantly higher (P-value=۰.۰۰۷) than in hypertensive patients without LVH (۱۳.۳۶%) and normotensive patients (۱۳.۹۹%). LVMD was significantly more common in men than women (P-value=۰.۰۰۰), but there was no significant association between age, body mass index, smoking, and hyperlipidemia with LVMD (P-value>۰.۰۵).Conclusion: Hypertension without LVH had no significant impact on the prevalence of LVMD, while hypertensive LVH was associated with LVMD therefore hypertensive patients with LVH and LVMD may need more intensive treatment and follow-up.

کلیدواژه ها:

Mechanical dyssynchrony ، Myocardial perfusion imaging ، Phase analysis ، Hypertension ، Left ventricular hypertrophy