Methods: Forty young patients with MH (age 18 ± 3 years, 73% males) and 40 age-, sex- and race-matched normotensive volunteers were recruited in our study. MH was diagnosed if daytime or night-time ambulatory blood pressure (ABP) = 95th percentile for gender and height according to the local reference. All study subjects underwent 24-hour ABP monitoring and completed two-dimensional echocardiography (2DE) including speckle-tracking analysis (2D-STE). Quantitative data were determined for left ventricular (LV) ejection fraction (EF), global circumferential strain (CS), longitudinal strain (LS) as well as strain rate.
Results: Ventricular volumes and LVEF were similar between the study groups. However, 2D-STE derived LV global LS and CS were significantly decreased in youth with MH when compared to true normotensives (all P < 0.05, Figure 1). Moreover, LV systolic and early diastolic longitudinal strain rates in MH subjects were lower than in control group (all P < 0.05, Figure 1), while late diastolic strain rates tended to increase in MH, although without statistically significance.
Conclusion: Youths with MH have evidence of subclinical LV systolic impairment evaluated by speckle-tracking analysis, despite of short disease course. Thus, MH in youth should be no longer considered an entirely benign entity.