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[Study of left ventricular diastolic function using pulsed Doppler in myocardial infarct in hypertensive subjects]
B Boudjemaa1, D Carrie, P Granier
1Clinique cardiologique hôpital Purpan, Toulouse, France.
Insights
Acute myocardial infarction worsens left ventricular diastolic dysfunction in patients with arterial hypertension. This study highlights how heart attack increases impaired left ventricular filling in hypertensive heart disease patients.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Context:
- Arterial hypertension is a significant risk factor for cardiovascular disease.
- Acute myocardial infarction (AMI) can lead to impaired left ventricular (LV) function.
- Hypertensive heart disease (HHD) involves structural and functional changes in the heart due to chronic hypertension.
Purpose:
- To investigate the impact of acute myocardial infarction on left ventricular diastolic function in patients with arterial hypertension.
- To compare diastolic function between patients with AMI and hypertension, AMI without hypertension, hypertension alone, and healthy controls.
Summary:
- Left ventricular diastolic function was assessed using pulsed Doppler echocardiography in 46 patients across four groups: AMI with HHD, AMI without hypertension, hypertension without coronary artery disease, and healthy controls.
- Measurements included peak early diastolic (E) and atrial systolic (A) mitral flow velocities, along with A/E and integrated A/integrated E ratios.
- No significant differences in ejection fraction or LV segmental kinetic were observed between AMI groups, suggesting diastolic function is the primary affected parameter.
Impact:
- Left ventricular filling is impaired in patients with both arterial hypertension and acute myocardial infarction.
- Acute myocardial infarction exacerbates the impairment of left ventricular diastolic function in patients with hypertensive heart disease.
- Findings underscore the complex interplay between hypertension, myocardial infarction, and diastolic dysfunction, informing clinical management strategies.
Abstract:
To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.2 (n = 12 pts) acute myocardial infarction without arterial hypertension. G.3 (n = 10 pts) arterial hypertension without history of coronary artery disease. G.4 (n = 12 pts) healthy subjects. Coronary angiography and left ventricular cineangiogram was performed in 24 pts (G.1 + G.2). Peak mitral flow velocity (cm/s) in early diastole (E), atrial systole (A), A/E and int A/int E ratios were measured by pulsed doppler. Age and heart rate were statistically similar in all groups. No difference was found among G.1 and G.2 in ejection fraction, and left ventricular segmental kinetic. (tables; see text) Conclusion left ventricular filling is impaired in pts with arterial hypertension and in pts with acute myocardial infarction; acute myocardial infarction increase the impairment of left ventricular diastolic function in pts with hypertensive heart disease.