Case:

This ultrasound is from a 55 year old man who has been treated for hypertension by the general practitioner with an ACE inhibitor for the last 5 year for hypertension. With this medication he has been normotensive during control visits. An ECG was made during follow up showing left ventricular hypertrophy. He was consequently seen at the cardiology outpatient department where the following findings were made with echocardiography.

Conventional ultrasound:

The LV systolic function is normal with an LVEF of 58%. There is concentric hypertrophy with a more pronounced septal thickness of maximal 15mm. The diastolic parameters fit with an impaired relaxation with normal left atrial pressure (E/E` of 9)

Deformation imaging

The deformation graphs show typical findings fitting with LVH due to hypertension. The global longitudinal strain (GLS) is normal with a value of -21.2%. There is a moderate reduction in systolic strain in the basal segment of the inferoseptum and anteroseptum, see “Post systolic index” figure below.

The following figures show the segmental strain values and deformation graphs. In the final figure (APLAX), note the moderate reduction of peak systolic strain (to a value between -16% and -18%) and the presence of post systolic strain. The corresponding graph has been highlighted in red.