Heart Failure with Preserved Ejection Fraction in Hypertensive Patients (Speckle Study) in Correlation with NT-proBNP

Objectives to detect the presence of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients through evaluating the involved cardiac dysfunction using two dimensional STE (2D-STE) derived GLS and NT-proBNP levels, then to correlate between them in our patients. Background Hypertension (HTN) is considered the greatest attributable risk factor for the incidence of HFpEF. Identification of subtle cardiac dysfunction involved in HFpEF is challenging. Speckle tracking echocardiographic (STE) has been recently used to detect cardiac dysfunction in HFpEF through measurement of global longitudinal strain (GLS). Nterminal- prohormone brain natriuretic peptide (NT-proBNP) remains the gold standard biomarker for HFpEF diagnosis and prognosis. Methods a prospective study conducted on 62 hypertensive patients and 62 healthy controls took part in the research. Doppler and STE data together with NT-proBNP levels were assessed in all subjects. Detecting HFpEF in hypertensive patients was done based on HFA-PEFF score recommended by recent ESC guidelines. Results patients were subdivided into 37 hypertensive patients with HFpEF patients (HFpEFHTN group) and 25 pure hypertensive patients (HTN group). HFpEF-HTN group had significantly lower GLS compared to HTN and control groups while NT-proBNP levels showed significantly higher levels in HFpEF-HTN group compared to HTN and control groups. There was significant negative correlation between GLS and NT-proBNP in patients group, which was more significant in HFpEF-HTN group. Conclusion There is a strong correlation between GLS, measured by STE, and NT-proBNP levels among hypertensive patients especially those having HFpEF. Also found that STE could detect subclinical cardiac dysfunction in these patients.