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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
11:04

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

Published on: September 1, 2014

Diagnosis and management of left ventricular diastolic dysfunction in the hypertensive patient

Maurizio Galderisi1

  • 1Cardioangiology Unit with CCU, Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy. mgalderi@unina.it

American Journal of Hypertension
|December 18, 2010
PubMed

Insights

Hypertension can lead to heart failure with preserved ejection fraction (HFNEF) through left ventricular diastolic dysfunction (DD). Early diagnosis using echocardiography and managing blood pressure are key for hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Heart Failure Studies

Background:

  • Hypertension contributes to myocardial fibrosis and altered left ventricular (LV) geometry, leading to LV diastolic dysfunction (DD).
  • Diastolic dysfunction precedes systolic dysfunction and can cause heart failure with normal ejection fraction (HFNEF), a growing concern.
  • HFNEF prevalence is increasing, highlighting the need for effective diagnosis and management in hypertensive individuals.

Purpose of the Study:

  • To emphasize the clinical significance of diagnosing and managing LV diastolic dysfunction (DD) in hypertensive patients.
  • To highlight the role of Doppler-echocardiography in identifying DD.
  • To advocate for comprehensive diastolic function assessment focusing on LV filling pressure (FP) for prognosis.

Main Methods:

  • Utilizing Doppler-echocardiography for DD diagnosis.
  • Employing the E/e' ratio (transmitral E velocity to pulsed tissue Doppler-derived early diastolic velocity) for accurate LV filling pressure estimation.
  • Considering left atrial enlargement as an additional diagnostic marker.

Main Results:

  • The E/e' ratio is identified as a feasible and accurate method for assessing LV filling pressure.
  • Doppler-echocardiography is crucial for diagnosing DD, even in asymptomatic cases.
  • Left atrial enlargement can aid in diagnosing DD in ambiguous situations.

Conclusions:

  • Comprehensive assessment of diastolic function, particularly LV filling pressure via the E/e' ratio, is vital for managing hypertensive patients.
  • Management strategies should include blood pressure reduction and efforts to normalize LV geometry.
  • Further prospective studies are needed to confirm the prognostic benefits of current management approaches for DD and HFNEF in hypertension.

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