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Abstract Hypertension is an important public health challenge in both economically developing and developed countries. Hypertension is a risk for many complications including coronary heart disease, stroke, congestive heart failure, peripheral vascular disease and end stage renal disease. Recent analyses have shown that as of the year 2000, there were 972 million people living with hypertension worldwide, and it is estimated that this number will escalate to more than 1.56 billion by the year 2025. Hypertension is most commonly defined as sustained elevation of resting systolic BP (≥140mmHg), diastolic BP (≥90mmHg), or both on two subsequent clinical visits one week apart. LV systolic and diastolic dyssynchrony is a common finding in patients with hypertension. The aim of our study was to assess LV dyssynchrony in hypertensive patients with normal systolic function by tissue synchronization imaging. Automated tissue synchronization imaging enables rapid, reproducible intra-ventricular dyssynchrony assessment and overcomes some of the limitations of conventional techniques. The study involving two groups: Group A: (51) hypertensive patients with good left ventricular systolic function (EF≥50%) and narrow QRS on the ECG (<120 msec), and we excluded candidates with any of the following: history of congestive heart failure, history of ischaemic heart disease, diabetes mellitus, atrial fibrillation, significant valvular heart disease, chronic renal failure, pulmonary hypertension, myocardial or pericardial disease. Group B: (20) age and sex matched healthy volunteers represent the control group. The mean age of the hypertensive patients was (52.02±10.009) and the mean age of the control subjects was (49.55±7.104). The hypertensive group was divided into 11 males (21.6%) and 40 females (78.4%), while the control group was divided into 10 males (50%) and 10 females (50%). Our study showed that the majority of hypertensive patients already on more than one of anti-hypertensive medications. More than 72% of the patients on angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARBS) and only 15.8% on beta blocker (BB) treatment. In our study , We found in conventional echo examination that hypertension was highly significantly associated with increase of septal wall and posterior wall thickness In our study we investigated LV dyssynchrony by tissue synchronization imaging (TSI) method which showed that the delay between septal and lateral walls was significantly higher in hypertensive patients than in controls . In our study we found that the correlations between conventional echo parameters and tissue synchronization imaging parameters in patients and controls showed that there were significant positive correlation between septal lateral delay and each of LVEDD and LV mass in hypertensive group. Similarly there were significant negative correlation between septal posterior delay and each of septal thickness and posterior wall thickness in hypertensive patients. Also there were significant positive correlation between all segmental maximum difference and each of LVEDD and LV mass in hypertensive group but there were significant negative correlation with each of septal thickness and LV mass in control group. And finally a significant positive correlation between dyssynchrony index and each of LVEDD and LV mass in hypertensive group but there was significant negative correlation with septal thickness in control group . |