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[Exploration of left ventricular relaxation using gamma-angiography in 70 hypertensive subjects. Practical
J P Ollivier1, J F Gaillard, J Delonca
1Service de cardiologie hôpital militaire du Valde-Grâce, Paris.
Insights
Hypertension can lead to left ventricular diastolic dysfunction, impacting heart function. Many hypertensive patients show reduced peak filling rate, indicating potential diastolic issues despite normal ejection fraction.
Area of Science:
- Cardiology
- Physiology
Background:
- Hypertension is a major risk factor for cardiovascular diseases.
- Left ventricular diastolic dysfunction (LVDD) is an early indicator of cardiac impairment.
Purpose of the Study:
- To assess the incidence and clinical significance of LVDD in hypertensive patients.
- To evaluate early diastolic function indices in mild to moderate hypertension.
Main Methods:
- Utilized rest equilibrium blood pool scintigraphy to measure peak filling rate (PFR) and time to peak filling rate (TPFR).
- Included 70 hypertensive patients and 15 healthy controls.
- Assessed ejection fraction and stress test results.
Main Results:
- While overall PFR was not significantly different, 84% of hypertensive patients had lower individual PFR values than expected.
- TPFR showed no significant difference between groups.
- A subgroup with arrhythmias exhibited significantly slower PFR.
Conclusions:
- Hypertension is associated with subclinical LVDD, detectable by reduced PFR.
- Early diastolic indices like PFR offer insights into left ventricular filling abnormalities.
- Further research is needed to understand the determinants of LVDD in hypertension.
Abstract:
This study was performed to evaluate the incidence ant the practical consequences of left ventricular diastolic dysfunction in hypertensive. In 70 mild to moderate hypertensive subjects group [systolic 161 +/- 16 and diastolic blood pressure 104 +/- 9 mmHg 18 women, 52 men, 51 +/- 7 years old] and in a 15 normal subjects control group, the peak filling rate (PFR) and the time to peak filling rate (TPFR) were measured with the time/activity curve of the rest equilibrium blood pool scintigraphy. The ejection fraction and the stress test were normal in all patients [EF 0.66 +/- 0.05, ranging from 0.59 to 0.88]. The PFR was not significantly different in the hypertensive group but 59/70 patients [84 p. 100] showed an individual value lower than the theoretical age and heart rate expected value. The TPFR was not significantly different (183 +/- 33 ms-vs 180, p = ns). In a Holter-defined sub-group of patients (n = 22) exhibiting a high prevalence of supra-ventricular premature beats or a paroxysmal atrial fibrillation, the PFR was significantly slower than in the total hypertensive group [1.92 +/- 0.33 EDV/s-1, p = 0.02]. Early indices of diastolic function give some instantaneous information on left ventricular filling. Determining the exact significance of individual values of PFR and TPFR requires a better knowledge of physiologic and pathologic determinants of LV filling.