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[Evaluation of diastolic function by transmitral color M-mode flow propagation velocity in hypertensive patients]
Cevad Sekuri1, Talat Tavli, Selahattin Danahaliloğlu
1Department of Cardiology, Medical Faculty, Celal Bayar University, Manisa. csekuri@superonline.com
Insights
Flow propagation velocity (FPV) measured by color M-mode echocardiography correlates with key indicators of left ventricular relaxation in hypertensive patients. This method offers a valuable tool for assessing diastolic function, unaffected by minor filling pressure changes.
Area of Science:
- Cardiology
- Echocardiography
- Hypertension Research
Background:
- Diastolic dysfunction is a primary driver of heart failure and morbidity in hypertensive individuals.
- Accurate assessment of left ventricular relaxation is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate the relationship between transmitral diastolic color M-mode flow propagation velocity (FPV) and left ventricular relaxation.
- To evaluate FPV as a potential echocardiographic marker for diastolic function in hypertension.
Main Methods:
- Thirty-nine hypertensive patients (Stage I and above) were studied.
- Doppler echocardiography was used to measure transmitral diastolic velocities (E, A), E-deceleration time (DT), and isovolumic relaxation time (IVRT).
- Color M-mode echocardiography was employed to measure flow propagation velocity (FPV) of transmitral diastolic flow.
Main Results:
- FPV showed a significant negative correlation with E-deceleration time (DT) (r=-0.715, p<0.01) and isovolumic relaxation time (IVRT) (r=-0.736, p<0.01).
- FPV also correlated with interventricular septum thickness (r=-0.498, p<0.01) but not with the E/A ratio.
- FPV values did not show a statistical relationship with age and gender, though a decreasing trend was observed in patients over fifty years old.
Conclusions:
- Color M-mode FPV is significantly correlated with DT and IVRT, key parameters for diastolic function assessment in hypertension.
- FPV is directly related to left ventricular relaxation and can be considered a valuable, routine echocardiographic parameter.
- FPV is not influenced by minor changes in left ventricular filling pressure, enhancing its clinical utility.
Objective:
Diastolic dysfunction is considered as the most important cause of heart failure and morbidity in hypertensives. This study was designed to evaluate the relationship between the transmitral diastolic color M-mode flow propagation velocity (FPV) and left ventricular relaxation by using Doppler echocardiography.
Methods:
In the present study, thirty-nine patients (21 male, 58.3%, age mean 52.7+/-5.9 years) with hypertension stage-I and over, were included. Transmitral diastolic E and A velocities, E-deceleration time (DT) and isovolumic relaxation time (IVRT) were measured by pulse Doppler method. We performed color M-mode technique for measurement of FPV of transmitral diastolic flow in the apical four-chamber view. We measured slope of aliasing velocity (blue aliasing) determined by color M-mode images.
Results:
Flow propagation velocity values were not statistically related with age and gender, whereas differentiation of age groups were estimated as poor parabolic relationship, specially in patients over fifty years, FPV is estimated to be decreasing. Color M-mode FPV is correlated with DT, (r=-0.715, p<0.01), IVRT (r=-0.736, p<0.01) and interventricular septum thickness (r=-0.498, p<0.01), but not correlated with E/A ratio.
Conclusion:
Color M-mode FPV is correlated with DT and IVRT, which are important parameters for evaluation of diastolic function in hypertensive patients. This parameter is related with left ventricular relaxation and should be considered as a routine echocardiographic evaluation, because it is not affected by minimal changes in left ventricular filling pressure.
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