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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Published on: September 1, 2014

Assessment of diastolic dysfunction in elderly hypertensive patients using integrated Doppler echocardiography

Mónika Dénes1, István Kiss, Mária Lengyel

  • 1Gottsegen György Hungarian Institute of Cardiology, Budapest, Budapest, Hungary.

Blood Pressure
|June 2, 2009
PubMed

Insights

Many elderly hypertensive patients have asymptomatic diastolic dysfunction (DD). Advanced echocardiography, including Tissue Doppler imaging (TDI) and Pulmonary venous (PV) flow, helps detect elevated filling pressures even with normal mitral inflow patterns.

Area of Science:

  • Cardiology
  • Echocardiography
  • Diastolic Function Assessment

Background:

  • Elderly hypertensive patients with preserved systolic function may have undiagnosed diastolic dysfunction (DD).
  • Routine echocardiography might not fully capture the nuances of diastolic function in this population.
  • Tissue Doppler imaging (TDI) and Pulmonary venous (PV) flow assessment can provide additional insights.

Purpose of the Study:

  • To assess stages of diastolic dysfunction (DD) in elderly, asymptomatic, hypertensive patients with preserved systolic function.
  • To investigate the utility of TDI and PV flow in routine echocardiography for evaluating diastolic function.
  • To identify prevalence of elevated filling pressures (EFP) in this cohort.

Main Methods:

  • 322 elderly hypertensive patients (age 70.8±9.1 years) with preserved systolic function were enrolled.
  • Diastolic function was evaluated using mitral inflow patterns, TDI (Ea: early diastolic velocity), and PV flow.
  • Elevated filling pressure (EFP) was defined by specific criteria including deceleration time, E/Ea ratio, and PV flow S/D ratio.

Main Results:

  • Moderate-to-severe DD was found in approximately one-third of patients (109/322).
  • Early diastolic velocity (Ea) was significantly decreased in patients with mild and moderate DD compared to those without DD.
  • 58% of patients with a normal mitral inflow pattern exhibited elevated filling pressures (EFP).

Conclusions:

  • A significant proportion of elderly hypertensive patients with preserved systolic function have moderate-to-severe asymptomatic diastolic dysfunction.
  • TDI and PV flow assessment are valuable additions to routine echocardiography for detecting elevated filling pressures.
  • Elevated filling pressures can be present even in the presence of a normal mitral inflow pattern, highlighting the need for advanced assessment.
Abstract

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