Hypertension is responsible for many structural changes with myocardial fibrosis leading to left ventricular hypertrophy and progressive deterioration over time of systolic left ventricular and diastolic function. Hypertension and type 2 diabetes are major causes of ventricular dysfunction and heart failure risk factors. Current data suggest that the longitudinal LV systolic dysfunction was found in the early stages of hypertensive cardiomyopathy. Recently, the development of the imaging (2D) strain has facilitated simple and independent measurement of LV strain parameters in the longitudinal, circumferential and radial.

This work is to achieve in a series of 30 hypertensive patients with diabetes and 30 non diabetic hypertensive patients (aged 25-75 years) a complete echo cardiographic study, including LVEF biplane Simpson method, calculation of left ventricular mass indexed and the relative thickness parietal to differentiate the eccentric and concentric left ventricular hypertrophy(LVH), analysis of diastolic function and finally the study of the longitudinal strain of LV by speckle tracking technique (calculation GLS).Were excluded from the study patients with secondary hypertension, valvular stenosis or fleeting, arrhythmia, coronary artery disease history.

60 diabetic patients and non-diabetic hypertensive had an LVEF greater than 55% as measured by biplane Simpson method and the conventional method.

LVH was present in 85% of diabetic hypertensive against 45% in non-diabetics.The calculation of LV mass according to the ASE method was used to select 20 diabetic patients with concentric LVH against 5 with eccentric LVH.

The LV mass index was higher with an average of 120g/m² in diabetic patients with LVH compared with non-diabetic patients with LVH.

The evaluation of filling pressures by the E/E ’showed high pressures in 8 diabetic hypertensive patients against only 3 non-diabetic hypertensive patients.

Analysis of longitudinal function by calculating the GLS showed lower rates to 18% in 18 diabetic hypertensive patients against 9 nondiabetic hyper-tensive patients.

GLS was lower than –18% in eight diabetic patients with filling pressures high. We note in this modest work that LVH was clearly predominant in the HTA arm+diabetes with a consequent decrease in longitudinal contraction index. In diabetic hypertensive patients, LVH was generally concentric. Elevated filling pressures was found in 8 diabetic hypertensive patients against only 3 non-diabetic hypertensive patients, with good correlation with the decrease in the GLS.

In conclusion, the evaluation of longitudinal systolic function by 2D strain has an important role in the early detection of subclinical heart disease in diabetic hypertensive patients, and could thus identify patients at high risk of heart failure may benefit from preventive strategies