الفهرس 
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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 .