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Right ventricular diastolic function in systemic hypertension
S Chakko1, E de Marchena, K M Kessler
1Department of Medicine, University of Miami School of Medicine, Florida.
Insights
Essential hypertension impairs right and left ventricular diastolic function. These abnormalities in ventricular filling are closely related between the right ventricle (RV) and left ventricle (LV).
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Essential hypertension is a common condition with known effects on left ventricular structure and function.
- The impact of essential hypertension on right ventricular (RV) diastolic function is less understood.
Purpose of the Study:
- To evaluate right (RV) and left ventricular (LV) diastolic function in patients with mild essential hypertension.
- To determine the relationship between RV and LV diastolic function in this population.
Main Methods:
- Pulsed-wave Doppler echocardiography was used to assess diastolic function in 50 hypertensive patients and 10 controls.
- Patients with other cardiac conditions were excluded, and antihypertensive medications were stopped prior to the study.
Main Results:
- Hypertensive patients showed impaired RV diastolic function, including higher peak atrial filling velocity and prolonged deceleration half-time.
- Abnormalities in RV filling parameters, such as a lower early/atrial filling velocity ratio and peak filling rate, were observed.
- Left ventricular (LV) filling parameters exhibited similar changes, and RV filling parameters correlated well with corresponding LV parameters.
Conclusions:
- Right ventricular (RV) diastolic function is abnormal in patients with mild essential hypertension.
- These RV diastolic abnormalities are closely linked to the diastolic dysfunction observed in the left ventricle (LV).
Abstract:
Right (RV) and left ventricular (LV) diastolic function was evaluated in 50 patients with mild, uncomplicated essential hypertension using pulsed-wave Doppler echocardiography. Patients with pulmonary, valvular or coronary artery disease were excluded and antihypertensive drugs were discontinued for the 2 weeks preceding the study. Ten normotensive patients without heart disease acted as control subjects. In the hypertensive patients, RV peak velocity of atrial filling was higher (42 +/- 10 vs 31 +/- 7 cm/s, p less than 0.01) and deceleration half-time was prolonged (96 +/- 20 vs 83 +/- 10 ms, difference not significant); ratio of early/atrial filling velocity (1.1 +/- 0.3 vs 1.7 +/- 0.4, p less than 0.001) and peak filling rate corrected to stroke volume (3.6 +/- 0.7 vs 5.3 +/- 0.9 SV/s, p less than 0.001) were lower. LV filling parameters showed similar changes. RV filling parameters did not correlate with age, LV mass or septal thickness but correlated weakly with LV radius/thickness ratio. There was good correlation between RV and the following corresponding LV filling parameters: peak filling rate, r = 0.68, p less than 0.001; ratio of early/atrial filling, r = 0.88, p less than 0.0001; and deceleration half-time, r = 0.62, p less than 0.001. Data indicate that RV diastolic function is abnormal in essential hypertension and these abnormalities are closely related to those of LV diastolic function.