REVIEWSHypertensive heart disease beyond left ventricular hypertrophy are we ready for echocardiographic strain evaluation in everyday clinical practice?Tadic, Marijanaa; Cuspidi, Cesareb; Bombelli, Michelec; Grassi, Guidoc,d Author Information aDepartment of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Berlin, Germany bClinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda cClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca dIRCCS Multimedica, Sesto San Giovanni, Milano, Italy Correspondence to Marijana Tadic, MD, PhD, Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353 Berlin, Germany. E-mail: [email protected]. Abbreviations: 2DE, two-dimensional echocardiography; LV, left ventricle Received 7 August, 2017 Revised 1 October, 2017 Accepted 31 October, 2017 Journal of Hypertension: April 2018 - Volume 36 - Issue 4 - p 744-753 doi: 10.1097/HJH.0000000000001632 Buy Metrics Abstract Hypertension-induced left ventricular (LV) remodeling is a well known entity that has usually been studied with traditional echocardiographic techniques. In the last decade echocardiographic methods are focused on evaluation of heart mechanics. The strain assessment is considered as part of comprehensive echocardiographic examination. Nevertheless, LV strain and particularly longitudinal strain was proofed as a significant independent predictor of cardiovascular and total morbidity and mortality, stronger than LV ejection fraction. Considering the fact that hypertensive heart disease represents one of the most important risk factors for the development of heart failure with preserved ejection fraction, one should be careful and accurate in identifying subtle signs of cardiac dysfunction. The early detection of cardiac dysfunction by conventional echocardiographic methods is often not possible. The aim of the current article is to overview the main principles of LV mechanics and summarize the current knowledge and clinical significance of LV strain in hypertensive patients. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.