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[Doppler analysis of mitral flow in mild to moderate hypertension]
Insights
Hypertension significantly impacts left ventricular relaxation and compliance, indicated by thickened walls and altered diastolic filling patterns observed via Echo-Doppler. These changes suggest early cardiac damage in hypertensive patients.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Context:
- Mild to moderate hypertension is common and can lead to cardiac remodeling.
- Early detection of cardiac dysfunction is crucial for managing hypertension.
- Echo-Doppler (echocardiography with Doppler) is a key non-invasive tool for assessing cardiac function.
Purpose:
- To evaluate left ventricular relaxation disturbances in patients with mild to moderate hypertension using Echo-Doppler.
- To compare cardiac structural and functional parameters between healthy individuals and hypertensive patients.
Summary:
- Hypertensive patients (n=40) exhibited significantly increased septal and posterior wall thickness, and left ventricular mass compared to healthy controls (n=15).
- Transmitral flow Doppler revealed prolonged isovolumetric periods, reduced early diastolic filling, and impaired deceleration, indicating relaxation disturbance and compliance damage.
- Higher atrial filling contribution and altered E/A ratios (age-corrected) further support diastolic dysfunction in hypertensive individuals.
Impact:
- This study highlights Echo-Doppler's utility in identifying subclinical cardiac changes in hypertension.
- Findings underscore the detrimental effects of hypertension on left ventricular diastolic function, even at mild to moderate stages.
- Early identification of these relaxation and compliance issues can inform timely therapeutic interventions to prevent further cardiac damage.
Abstract:
We evaluate by Echo-Doppler the left ventricular relaxation disturbance produced by mild to moderate hypertension. It's a comparative study between 15 healthy and 40 patients with hypertension (diastolic blood pressure between 90-114 mmHg and/or systolic greater than 160 mmHg). Echocardiography was performed in all cases and diameters, thickness, volumes, ejection fraction, mass, transmitral flow by Doppler and cardiac output were evaluated . In hypertensive patients the septal and posterior wall thicknesses were significantly higher (1.39 +/- 0.2 cm vs 1.1 +/- 0.1, p less than 0.001 cm. and 1.26 +/- 0.12 cm vs 0.98 +/- 0.1 cm, p less than 0.001), and also the absolute mass and corrected according to corporal surface (339 +/- 58 g vs 203 +/- 44, p less than 0.001, and 185 +/- 34 g/m2 vs 115 +/- 16, p less than 0.001). In transmitral flow Doppler the higher isovolumetric period and lower diastolic filling in the first 1/3 (71 +/- 19 msec vs 53 +/- 20, p less than 0.05, and 35 +/- 5% vs 52 +/- 4%, p less than 0.001) are indicators of relaxation disturbance. A lower deceleration of early inflow and a higher deceleration time (265 +/- 98 cm/sec2/vs 454 +/- 139, p less than 0.001, and 226 +/- 38 msec vs 156 +/- 15, p less than 0.001) show compliance damage. The atrial filling was significantly higher in hypertensive patients (37 +/- 7% vs 20 +/- 8%, p less than 0.001). The E/A ratio, separate both groups but corrected by the age the signification was rather lower.(ABSTRACT TRUNCATED AT 250 WORDS)