Background: Ambulatory Blood pressure parameters suggested that had a relationship with subclinical Left ventricular systolic dysfunction assessed by speckle tracking echocardiography. Objectives: To know the relationship between ambulatory Blood pressure parameters and subclinical Left ventricular systolic dysfunction assessed by speckle tracking echocardiography. Material and Methods: we enrolled 70 consecutive patients with hypertension. All patients will be evaluated for parameters of Arterial blood pressure monitoring & speckle tracking echocardiography. ECG was done to show LVH. Ambulatory blood pressure monitoring showed different blood pressure parameters and AASI. Conventional Echocardiography showed mainly LV systolic function, Speckle Tracking Echocardiography showed subclinical LV systolic dysfunction. Results: The study consisted of 70 patients 30% were men. The mean age of the patients was 46.7±12 years. Fifty nine patients were on antihypertensive drugs, 31 patients (44%) were controlled on treatment, and 56 patients (80%) were compliant. forty-two patients (60%) showed LVH by ECG criteria. ABPM Mean SBP: Day time134.5±15 mmHg, ABPM Mean SBP: night time: 128.4±16 mmHg, ABPM Mean DBP: Day time: 79.6±19 mmHg, ABPM Mean DBP: night time: 75.3±11mmHg and mean AASI: 0.66±0.16. Study population were divided into 2 groups according to blood pressure control; controlled (n=31%), and uncontrolled (n=39%). Baseline characteristics data were compared between both groups. The rate of LVH in ECG was significantly higher in the uncontrolled group (p< 0.05). There were significant differences in both day-time and night-time mean ABPM (p<0.05). However, there were no significant difference between AASI and dipping pattern between both groups (p= 0.3, and 0.1 respectively). Posterior wall thickness LV mass, as well as LV relative wall thickness were significantly higher in uncontrolled patients (p<0.05 for all). Interestingly only GCS and not GLS were significantly different between both groups (p< 0.05, p=0.3 respectively). Also, there was significantly more concentric hypertrophy and remodeling in uncontrolled patients group (p<0.05). --), ASSI was significantly, but moderately, associated with most ambulatory blood pressure parameters. It was also significantly associated with GLS; on the other hand, AASI did not show significant association with GCS. Mean GLS and mean GCS in hypertensive individuals were -16.4±3, -17.1±4 respectively. GLS varied significantly according to the presence of altered LV geometry, particularly reduced longitudinal systolic strain in those with concentric remodeling. Furthermore, longitudinal systolic strain parameters were significantly reduced in individuals with increased LA Volume index, and severity of diastolic dysfunction. Age was significantly higher in the high AASI group (AASI>0.5) (p<0.5). Most ABPM parameters were higher with the higher AASI values. Significantly more uncontrolled hypertensive patients were encountered in the high AASI group (p<0.05). Interestingly, only LAVI was significantly higher among the high AASI group (p<0.05). Gender and AASI are predictors of impaired GLS by a univariate analysis (Beta=-0.288, CI= -3.5:-0.06 and p = 0.04 for gender & Beta=0.319, CI= 0.82:11and p = 0.02 for ASSI), however ASSI was the only predictor of impaired GLS by multivariate analysis (Beta=0.3, CI= 0.2:12, and p = 0.04). Age is the only predictor of impaired GCS by a univariate and multivariate analysis.Conclusion: ASSI was the only predictor of impaired GLS .Age is the only predictor of impaired GCS. so, there were a strong relationship
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between blood pressure parameters especially ASSI and GLS measured by speckle tracking echocardiography.