Related Experiment Video
Updated: Jul 28, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Diastolic function and tachycardia in hypertensive children
M C Johnson1, L J Bergersen, A Beck
1Division of Cardiology, St Louis Children's Hospital, Missouri 63110, USA.
Insights
Untreated hypertensive children show impaired left ventricular relaxation, indicated by Doppler echocardiography. Resting heart rate was the strongest predictor of these diastolic function abnormalities.
Area of Science:
- Cardiology
- Pediatrics
- Hypertension Research
Background:
- Pediatric hypertension is a growing concern with potential long-term cardiovascular consequences.
- Diastolic dysfunction, an early indicator of cardiac impairment, may be present in hypertensive children.
Purpose of the Study:
- To investigate the prevalence of diastolic dysfunction using Doppler echocardiography in untreated hypertensive children.
- To identify potential predictors of impaired diastolic function in this population.
Main Methods:
- Retrospective review of Doppler and M-mode echocardiographic data from 42 untreated hypertensive children and 39 age/gender-matched normotensive controls.
- Comparison of various echocardiographic parameters, including mitral inflow velocities, isovolumic relaxation time, and left ventricular mass index.
Main Results:
- Hypertensive children exhibited increased body mass index, peak mitral A velocity, isovolumic relaxation time, heart rate, mitral E deceleration time, left ventricular mass index, and relative wall thickness.
- A decreased ratio of peak mitral E velocity/peak mitral A velocity was observed in hypertensive patients.
- Resting heart rate and systolic blood pressure predicted peak mitral A velocity; heart rate, BMI, and indexed left ventricular diastolic dimension predicted the E/A velocity ratio.
Conclusions:
- Untreated hypertensive children demonstrate Doppler echocardiographic indices suggestive of impaired left ventricular relaxation.
- Resting heart rate emerged as the most significant predictor of abnormal diastolic indices in hypertensive children.
Abstract:
We investigated the prevalence and potential predictors of Doppler echocardiographic evidence of diastolic function in untreated hypertensive children. Doppler and M-mode echocardiographic values from 42 children (mean age 13, range 5-17 years) from a pediatric hypertension clinic were retrospectively reviewed and compared to data from 39 age and gender matched normotensive children in a control group. Compared to the participants in the control group, hypertensive patients had increased mean body mass index (29 v 19 kg/M2, P < .0001), peak mitral A velocity (57 v 42 cm/sec, P < .0001), isovolumic relaxation time (65 v 42 msec, P < .0001, resting heart rate (90 v 74 bpm, P < .0001), mitral E deceleration time (150 v 137 msec, P = .006), indexed left ventricular mass index (32 v 26 g/M2.7, P < .0001), relative left ventricular wall thickness (0.32 v 0.29, P = .02), and decreased ratio of peak mitral E velocity/peak mitral A velocity (1.7 v 2.1, P = .0001). Mean age, height, mitral E velocity, mitral A deceleration time, fractional shortening, and indexed left ventricular diastolic dimension were similar in patients and control group children. In the hypertensive patients, multivariate analysis demonstrated that heart rate (P = .0008) and systolic blood pressure (P = .03) were significant predictors of peak A velocity. In addition, heart rate (P = .0003), body mass index (P = .04), and indexed left ventricular diastolic dimension (P = .04) predicted the ratio of peak E/peak A velocity. None of the measures of diastolic function correlated with left ventricular mass index or relative wall thickness. Furthermore, none of the analyzed variables predicted isovolumic relaxation time or mitral E deceleration time. We conclude that untreated hypertensive children have Doppler indices suggestive of impaired left ventricular relaxation. Resting heart rate was the strongest predictor of abnormal diastolic indices.
More Related Videos
07:49A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
08:57Pulsed Wave Doppler Assessment of Diastolic Dysfunction in the ZSF-1 Rat Model of Pulmonary Hypertension Due to Left Heart Disease
Published on: May 22, 2026
Related Concept Videos
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Hypertension and Regulation of Blood Pressure
Heart Failure II: Pathophysiology
Hypertension I: Introduction
Hypertension II: Pathophysiology
Hypertension III: Clinical Manifestations and Diagnostic Studies