Introduction: L’hypertension est un problème de santé majeur dans le monde, elle est associée à une altération de la fonction de l’oreillette gauche (OG). L’analyse de la déformation myocardique à l’aide de l’échocardiographie s’avère un outil prometteur pour évaluer de la fonction auriculaire gauche. Objectif : Evaluer les changements précoces du strain atrial gauche chez des patients souffrant d’hypertension. Methodes : Le strain de l’OG a été étudié chez 109 patients hypertendus sans dilatation de l’OG et 50 témoins appariés selon l’âge. Des évaluations échocardiographiques bidimensionnelles et en speckle tracking ont été réalisées et les paramètres suivants ont été mesurés : le pic longitudinal du strain atrial gauche et la vitesse du strain pendant les périodes de la phase réservoir, de la phase conduite et de la contraction atriale gauche dans les vues à quatre et deux chambres. Le temps nécessaire pour atteindre le pic longitudinal du strain atrial gauche et la vitesse du strain ont été mesuré durant les trois phases de la fonction OG Resultats : Le diamètre antéropostérieur était normal, aucune différence entre les patients hypertendus et les témoins n’a été notée (34.35 mm ±4.91 vs 31.82 mm±4.87, p= 0.16). Les volumes maximum (41.78±10.29 vs 47±13.21, p= 0,01), minimum (23.95±12.18 vs 16.94±7.91, p=0,001) de l’OG étaient plus élevés chez les patients hypertendus qui avaient des fonctions réservoir (31.23% ±9.93 vs 46.43% ±11.06, p=0.000) et de conduction de l’OG (14.26%±2.91 vs 21.41%±2.8 , p= 0,000) altérées par rapport aux patients normotendus. Au cours de la période contractile, le pic du strain de OG (16.73 ±3.84 vs 15.29±2.75, p=0,07) ainsi que le pic de sa vitesse étaient (-1.89%±0.16, -1.82%±0.21; p=0,54) plus élevés chez les patients hypertendus sans atteindre le seuil de significativité. Le temps d’atteinte du pic du strain de OG à la phase réservoir (405.02ms±55.51 vs 387.13ms±47.48, p=0,05) et la durée de la diastole (163ms±26 vs 146ms±24, p= 0,04) étaient significativement plus élevés chez les patients hypertendus que chez les témoins. Une relation de corrélation significative entre les paramètres de l’étude volumétrique et ceux du speckle tracking a été notée. Conclusion : Le strain longitudinal a la phase réservoir et conduite est altéré chez les patients ayant une hypertension artérielle malgré une normalité de la taille des cavités cardiaque et avant même l’altération des autres paramètres échocardiographies conventionnels. Le speckle tracking est un outil prometteur de la détection des altérations précoces de l’OG

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