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Factors influencing transmitral flow velocity in normal and hypertensive subjects
T Pasierski1, Z C Miskiewicz, A C Pearson
1Department of Hypertension and Angiology, Academy of Medicine, Warsaw.
Insights
Hypertension alters transmitral flow patterns, showing decreased early filling and increased late filling velocities. These changes in mitral inflow are not directly linked to blood pressure or left ventricular geometry in hypertensive men.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Hypertension is a major cardiovascular risk factor.
- Understanding diastolic function is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate transmitral flow velocity patterns in hypertensive men using Doppler echocardiography.
- To identify determinants of altered mitral inflow in hypertension.
Main Methods:
- Doppler echocardiography was used to assess transmitral flow velocities.
- Evaluated early and late maximal transmitral velocity and flow velocity integrals.
- Compared 53 hypertensive men with 32 age-matched healthy normotensive men.
Main Results:
- Hypertensive men exhibited reduced early maximal transmitral velocity and normalized early flow integral.
- Hypertensive men showed increased late maximal flow velocity and normalized late flow integral.
- 47% of hypertensive subjects had abnormally high late transmitral flow; this was not related to blood pressure or ventricular geometry.
Conclusions:
- Hypertension is associated with distinct alterations in mitral inflow patterns.
- These mitral inflow changes are not solely explained by elevated blood pressure or altered left ventricular geometry.
- Age remains a significant determinant of transmitral flow in both hypertensive and normotensive individuals.
Abstract:
Transmitral flow velocity and its determinants were examined with Doppler echocardiography in 53 hypertensive and 32 age-matched healthy normotensive men. Early and late maximal transmitral velocity, and early and late flow velocity integral were evaluated. In comparison with normal subjects, hypertensive patients were characterized by decreased maximal early velocity (66.3 +/- 12.3 versus 72.3 +/- 11.5 cm/sec, p less than 0.05), normalized early flow integral (67 +/- 7% versus 73 +/- 5%, p less than 0.001), increased maximal late flow velocity (45 +/- 10 cm/sec, p less than 0.001), and normalized late flow integral (29 +/- 7% versus 21 +/- 5%, p less than 0.001). Abnormally high late transmitral flow was found in 47% of the hypertensive group. Multiple regression analysis revealed that in normal subjects transmitral flow indexes were determined by age, relative wall thickness, and systolic blood pressure, but not by heart rate. A strong relationship of Doppler transmitral flow indexes with age was confirmed in hypertensive patients; however, relative wall thickness influenced transmitral flow velocity only weakly and systolic blood pressure did not affect transmitral flow. Left ventricular mass and diastolic blood pressure did not influence mitral filling velocity in either group. The altered pattern of mitral inflow found in a large number of hypertensive subjects is not related to elevated arterial blood pressure or to altered left ventricular geometry.