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[The evaluation of left ventricular diastolic function by tissue Doppler echocardiography in essential hypertension]

Fang-Fang Wang1, Xin-Heng Feng, Bao-Xia Chen

  • 1Department of Cardiology, Peking University Third Hospital, Beijing, China.

Zhonghua Nei Ke Za Zhi
|July 26, 2011
PubMed

Insights

Essential hypertension impairs left ventricular diastolic function, detectable by both conventional pulse-wave Doppler echocardiography (cPWD) and Doppler tissue imaging (DTI). DTI, specifically Em and E/Em measurements, offers greater sensitivity in assessing diastolic dysfunction progression.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Hypertension Research

Background:

  • Essential hypertension is a prevalent condition associated with cardiovascular complications.
  • Left ventricular (LV) diastolic dysfunction is an early indicator of hypertensive heart disease.
  • Accurate assessment of diastolic function is crucial for managing hypertension.

Purpose of the Study:

  • To compare the efficacy of conventional pulse-wave Doppler echocardiography (cPWD) and Doppler tissue imaging (DTI) in evaluating LV diastolic function in patients with essential hypertension.
  • To identify which modality is more sensitive in detecting early diastolic dysfunction.

Main Methods:

  • Two hundred essential hypertension patients were categorized into normal LV mass (NLVH) and LVH subgroups, alongside 160 healthy controls.
  • Mitral valve flow pattern (MVFP) was assessed using cPWD to measure early (E) and late (A) diastolic velocities and the E/A ratio.
  • Doppler tissue imaging (DTI) was employed to measure the early diastolic mitral annular velocity (Em) and calculate the E/Em ratio.

Main Results:

  • Essential hypertension patients exhibited LV diastolic dysfunction by both cPWD (higher E, lower E/A ratio) and DTI (lower Em, higher E/Em ratio) compared to controls (P < 0.01).
  • The LVH subgroup showed significantly reduced Em and elevated E/Em compared to the NLVH subgroup (P < 0.05), with no significant difference in A or E/A.
  • These findings indicate impaired diastolic function in hypertensive individuals, with DTI parameters being more responsive to disease progression.

Conclusions:

  • Both cPWD and DTI are valuable tools for detecting diastolic dysfunction in the non-hypertrophic stage of hypertension.
  • Doppler tissue imaging (DTI) parameters, specifically Em and E/Em, demonstrate higher sensitivity and precision in reflecting the progression of diastolic dysfunction in hypertension.
Abstract

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