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Left ventricular hypertrophy and its regression in essential arterial hypertension. A tissue Doppler imaging study

Vitantonio Di Bello1, Davide Giorgi, Roberto Pedrinelli

  • 1Cardiac and Thoracic Department, University of Pisa, Pisa, Italy. vdibello@med.unipi.it

American Journal of Hypertension
|October 16, 2004
PubMed

Insights

Pulsed-wave tissue Doppler imaging (TDI) effectively detects early left ventricular diastolic dysfunction in hypertensive patients. TDI parameters show improvement with antihypertensive treatment, aiding in assessing disease progression and treatment response.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Hypertension Research

Background:

  • Essential hypertension is linked to left ventricular diastolic dysfunction.
  • Assessing diastolic function in hypertensive patients is crucial for early intervention.
  • Traditional methods may underestimate diastolic abnormalities in early stages.

Purpose of the Study:

  • To evaluate the efficacy of pulsed-wave tissue Doppler imaging (TDI) in assessing left ventricular (LV) diastolic function in never-treated essential hypertensive patients.
  • To compare TDI parameters with Doppler transmitral flow in discriminating diastolic dysfunction.
  • To observe the impact of antihypertensive treatment on TDI parameters and LV hypertrophy (LVH).

Main Methods:

  • Echocardiography was used to sample mitral annulus velocities via Doppler transmitral flow and pulsed-wave TDI.
  • 118 never-treated essential hypertensive patients and 59 normotensive controls were studied.
  • A subgroup of 26 hypertensive patients was followed for 1 year after antihypertensive treatment.

Main Results:

  • TDI parameters (E(m), A(m), E(m)/A(m)) were significantly altered in hypertensive patients with LVH compared to controls.
  • TDI E(m)/A(m) at the septal level discriminated normal from abnormal function in 91% of hypertensive patients, versus 25% for transmitral E/A ratio.
  • Antihypertensive treatment led to LVH regression and a trend toward normalization of TDI parameters, particularly E(m)/A(m).

Conclusions:

  • Pulsed-wave TDI is a sensitive tool for early detection of LV diastolic dysfunction in essential hypertension.
  • TDI can identify patients in adaptive or compensatory phases before irreversible damage.
  • TDI parameters show potential for monitoring treatment response and LVH regression.

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