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[The presence of diastolic dysfunction in hypertensive patients without left ventricular hypertrophy]
1Hospital General San Jorge, Huesca.
Insights
Hypertension impairs diastolic function independently of heart muscle thickening. Aging appears to be a key factor in this diastolic dysfunction in hypertensive patients.
Area of Science:
- Cardiology
- Internal Medicine
- Physiology
Background:
- Hypertension is linked to impaired diastolic left ventricular function.
- This study investigates if diastolic dysfunction occurs independently of myocardial hypertrophy in hypertensive patients.
Purpose of the Study:
- To determine if diastolic function is impaired in essential hypertension, irrespective of left ventricular hypertrophy.
- To assess the relationship between diastolic function indices and patient age or left ventricular mass.
Main Methods:
- Doppler echocardiography was used to measure early diastolic filling wave (VE) and late diastolic filling wave (VA).
- The VE/VA ratio was calculated as an index of diastolic function in 41 untreated essential hypertensive patients with normal systolic function.
Main Results:
- A reduced VE/VA ratio, indicating impaired diastolic function, was observed in 23 patients.
- Left ventricular hypertrophy was present in only 9 patients with reduced VE/VA ratio.
- The VE/VA ratio was significantly correlated with patient age (p < 0.01) but not with left ventricular mass.
Conclusions:
- Diastolic left ventricular function is impaired in hypertension, independent of myocardial hypertrophy.
- Age-related myocardial changes may be the primary drivers of diastolic dysfunction in hypertensive individuals.
Background:
Hypertension is associated with abnormalities in the diastolic left ventricular function. The present study was performed to evaluate whether diastolic function is impaired independently from myocardial hypertrophy.
Methods:
41 patients with essential hypertension who had never received antihypertensive therapy were evaluated. All patients had normal systolic function. VE wave, or early diastolic filling wave, and VA, or late diastolic filling wave, were measured by Doppler echocardiography, and the VE/VA ratio was used as index of diastolic function.
Results:
The VE/VA ratio was abnormally reduced in 23 patients, of which only 9 had left ventricular hypertrophy on echocardiographic criteria. The patients with a reduced ratio were older (p less than 0.01) than patients with a normal ratio. VE/VA ratio was not correlated with left ventricular mass, but it was correlated with age (r = 0.4186, p less than 0.01).
Conclusions:
Left ventricular diastolic function is impaired in hypertension independently from hypertrophy. The myocardial abnormalities associated with aging might be the major determinants of this functional impairment.