Related Experiment Video
Updated: Aug 7, 2026
Pulsed 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
Characterization of left ventricular diastolic function in hypertension by use of Doppler tissue imaging and color
Aleksandr Rovner1, Lisa de las Fuentes, Alan D Waggoner
1Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri 63110, USA.
Insights
Doppler tissue imaging (DTI) effectively assesses left ventricular (LV) diastolic dysfunction in hypertension (HTN) patients. DTI provides more accurate filling pressure measurements than pulsed wave Doppler and color M-mode (CMM).
Area of Science:
- Cardiology
- Medical Imaging
- Hypertension Research
Background:
- Left ventricular (LV) diastolic dysfunction, characterized by impaired relaxation or elevated filling pressures, is common in hypertension (HTN).
- Accurate assessment of diastolic function is crucial for managing HTN and preventing cardiovascular complications.
Purpose of the Study:
- To evaluate the clinical utility of pulsed wave Doppler, Doppler tissue imaging (DTI), and color M-mode (CMM) for determining diastolic function in hypertensive patients.
- To compare the effectiveness of these echocardiographic techniques in assessing LV relaxation and filling pressures.
Main Methods:
- A study involving 278 patients with normal LV systolic function, categorized into healthy controls (NC), HTN without LV hypertrophy (LVH), and HTN with LVH.
- Measurements included transmitral velocities (E, A), E/A ratio, deceleration time, isovolumic relaxation time, DTI-derived Em velocities, CMM-derived flow propagation velocity, and intraventricular pressure gradient.
- Statistical analysis using ANCOVA adjusted for age and sex compared diastolic indices among the groups.
Main Results:
- Doppler tissue imaging (DTI)-derived filling pressures showed statistically significant differences across all three groups (NC, HTN, HTN+LVH).
- Pulsed wave Doppler and CMM-derived indices, including flow propagation velocity and intraventricular pressure gradient, did not reveal significant differences among the groups.
Conclusions:
- Doppler tissue imaging (DTI) is a reliable method for quantitatively assessing LV relaxation and filling pressures in patients with hypertension.
- DTI demonstrates superior performance compared to pulsed wave Doppler and CMM for evaluating diastolic function in hypertensive individuals.
Background:
Abnormalities in left ventricular (LV) relaxation and/or increased filling pressures are indicators of LV diastolic dysfunction in patients with hypertension (HTN). The purpose of this study was to assess clinical use of pulsed wave Doppler, Doppler tissue imaging (DTI), and color M-mode (CMM) indices for determination of diastolic function in patients with HTN.
Methods:
In all, 278 ambulatory patients with normal LV systolic function were grouped according to the presence of HTN with and without LV hypertrophy (LVH) (determined by the 2-dimensional area-length method) as follows: healthy control subjects (NC, n = 122), HTN without LVH (HTN, n = 70), and HTN with LVH (HTN+LVH, n = 86). Pulsed wave Doppler-derived measurements included transmitral E- and A-wave velocities, E/A ratio, and deceleration and isovolumic relaxation time intervals; DTI-derived early diastolic (Em) velocities were obtained at 4 LV annular sites. CMM-derived flow propagation velocity and the intraventricular pressure gradient were also calculated. Analysis of covariance adjusted for age and sex of diastolic indices was performed to compare the differences among groups.
Results:
Only DTI-derived filling pressures demonstrated progressive statistically significant differences among all 3 groups (ie, HTN vs NC, HTN+LVH vs NC, and HTN vs HTN+LVH). However, CMM-derived flow propagation velocity and intraventricular pressure gradient indices were similar among the groups.
Conclusion:
DTI is a robust method compared with pulsed wave Doppler- and CMM-derived indices for the quantitative assessment of LV relaxation and filling pressures in patients with HTN.
