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.

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