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[Diastolic function of the hypertrophic left cardiac ventricle in hypertensive patients evaluated with Doppler
Insights
Hypertension significantly impairs left ventricular diastolic function, indicated by reduced early filling and increased atrial contribution. These changes in diastolic function are early signs of heart issues in hypertensive patients.
Area of Science:
- Cardiology
- Medical Imaging
Context:
- Hypertension is a prevalent condition associated with cardiovascular complications.
- Left ventricular hypertrophy (LVH) is a common adaptation to chronic hypertension.
- Diastolic dysfunction can precede systolic dysfunction in hypertensive heart disease.
Purpose:
- To investigate the impact of hypertension-induced concentric left ventricular hypertrophy on diastolic function using Doppler and 1D echocardiography.
- To identify early echocardiographic markers of diastolic dysfunction in hypertensive patients.
Summary:
- Patients with hypertension and LVH showed significantly impaired left ventricular diastolic function compared to healthy controls.
- Key indicators of diastolic dysfunction included reduced early diastolic filling (Ev), increased atrial contribution (Av), lower peak filling rate (PFR), and more pronounced early diastolic flow slowing (E-F).
- These diastolic abnormalities correlated with left ventricular mass and were consistent with TM echocardiogram assessments of myocardial relaxation.
Impact:
- Identifies specific echocardiographic parameters that reflect early diastolic dysfunction in hypertension.
- Highlights the potential of Doppler echocardiography for non-invasive assessment of cardiac changes in hypertensive patients.
- Suggests that impaired diastolic function is an early manifestation of hypertensive heart disease, preceding systolic alterations.
Abstract:
The authors examined by Doppler and one-dimensional echocardiography 20 patients with concentric hypertrophy of the musculature of the left ventricle and hypertension and 20 healthy subjects of similar age. As compared with the control group, they found in all patients deterioration of indicators of left ventricular diastolic function. The rate of blood flow in the early diastolic phase (Ev) was reduced and the ratio of the atrial contraction (Av) in the filling of the left ventricle increased (p less than 0.001). The maximal blood flow across the mitral orifice in early diastole (PFR) was lower (p less than 0.05) and the slowing down of the early diastolic flow (E-F) was more marked (p less than 0.001). The peak rate of relaxation (Vr) was also lower in the group of hypertonics (p less than 0.01). These disorders are an early sign of cardiac affection in hypertension and precede changes of systolic function. The impaired diastolic function is directly proportional to the weight of the left ventricle (for Av/Ev r = 0.76, PFR r = 0.68, E-F r = -0.82). The results of examinations obtained by Doppler echocardiography correlate with relaxation of the myocardium of the left ventricle assessed by computer processing of the TM echocardiogram (for Av/Ev r = 0.72, DHT r = 0.66, E-F r = 0.76).