Objective: Global longitudinal strain
is not well illustrated for the prognostic value in hypertension
. This observational study investigated the prognostic value of global longitudinal strain
, subendocardial longitudinal strain
, and subepicardial (EpiLS
) longitudinal strain
in regularly treated hypertensive patients.
Ninety-five hypertensive study participants (60.0% men, age 65.5 ± 12.0 years) were regularly treated for more than 1 year. We performed a two-dimensional echocardiographic study and obtained global peak systolic left ventricular longitudinal strain
of subendocardial myocardium and the subepicardium (defined as subendocardial longitudinal strain
, respectively). Cardiovascular events included cardiovascular death and any admission for stroke, acute coronary syndrome, or heart failure.
After a follow-up period of 7.3 ± 2.0 years, 20 (21%) study participants had cardiovascular events. Significant differences between study participants with and without cardiovascular events were noted in diuretic administration (75.0 vs. 93.3%, P
= 0.018), age (71.0 ± 11.6 vs. 64.0 ± 11.8 years, P
= 0.02) and EpiLS
(−16.0 ± 2.0 vs. −17.7 ± 3.0%, P
= 0.04). Using multivariate Cox regression analysis, EpiLS
was the only independent prognostic factor (hazard ratio 1.449, 95% confidence interval 1.027–2.045, P
= 0.035). Using the cut off value of −17.57% for EpiLS
(median value of EpiLS
), the Kaplan–Meier survival curve revealed a significant difference (P
= 0.016) associated with cardiovascular outcome.
was the only independent prognostic factor in regularly-treated hypertensive patients. Our results indicated that involvement of subepicardial myocardium may infer worse prognosis
of hypertensive heart disease.