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Assessment of left ventricular filling in patients with systemic hypertension. A Doppler echocardiographic study
P Faggiano1, C Rusconi, G Orlando
1Divisione di Cardiologia, Ospedale S. Orsola-Fatebenefratelli, Brescia, Italy.
Insights
Hypertension impairs left ventricular diastolic function, reducing early filling and prolonging filling times. This Doppler echocardiography study highlights diastolic dysfunction in hypertensive patients, even with normal systolic function.
Area of Science:
- Cardiology
- Medical Imaging
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Left ventricular (LV) diastolic dysfunction can precede systolic dysfunction in hypertensive patients.
- Early detection of diastolic dysfunction is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To evaluate left ventricular (LV) diastolic function in hypertensive patients using Doppler echocardiography.
- To assess transmitral blood flow (TBF) indices in hypertensive individuals with and without left ventricular hypertrophy (LVH).
- To compare diastolic function parameters between hypertensive patients and normal subjects.
Main Methods:
- A Doppler echocardiographic study of transmitral blood flow (TBF) was conducted.
- Participants included 46 hypertensive patients (18 without LVH, 28 with LVH) and 25 age-matched normal controls.
- Key Doppler TBF indices measured were peak early filling velocity (Evel), peak atrial systole velocity (Avel), E/A ratio, early filling area (Earea), atrial systole area (Aarea), Earea/Aarea ratio, and deceleration half-time (DHT).
Main Results:
- Hypertensive patients (both with and without LVH) demonstrated significantly reduced early filling indices (Evel, Earea) compared to normal subjects.
- An increased atrial contribution to diastolic filling (Avel, Aarea) was observed in hypertensive patients.
- Deceleration half-time (DHT) was significantly prolonged in hypertensive patients, indicating impaired diastolic relaxation.
Conclusions:
- Hypertension significantly impairs left ventricular diastolic function, characterized by reduced early filling and prolonged relaxation.
- Doppler echocardiography of transmitral blood flow is effective in detecting diastolic dysfunction in hypertensive patients.
- The presence of left ventricular hypertrophy exacerbates diastolic dysfunction in hypertensive individuals.
Abstract:
To assess left ventricular (LV) diastolic function in patients with hypertension, a Doppler echocardiographic study of transmitral blood flow (TBF) was performed in 46 hypertensive patients (H), 18 without (H1) and 28 with (H2) left ventricular hypertrophy and in 25 age-matched normal subjects (N). All patients showed normal systolic function. The following indices of Doppler TBF were measured: peak flow velocity during early filling (Evel), atrial systole (Avel) and their ratio (E/Avel); area under early filling phase (Earea), area under atrial systole (Aarea), expressed as a percentage of total diastolic area and their ratio (E/Aarea); deceleration half-time (DHT) of early filling phase. When compared with N, H1 and H2 showed significant reductions in early filling indices and an increase in atrial contribution parameters. (Evel = 0.62 +/- 0.1(N), 0.52 +/- 0.1(H1) P less than 0.01, 0.44 +/- 0.1(H2) P less than 0.001; Earea = 56 +/- 5(N), 48 +/- 5(H1) P less than 0.001, 43 +/- 6(H2) P less than 0.001; Avel = 0.49 +/- 0.1(N), 0.59 +/- 0.1(H1) P less than 0.01, 0.69 +/- 0.14(H2) P less than 0.001; Aarea = 26 +/- 5(N), 41 +/- 4(H1) P less than 0.001, 47 +/- 7(H2) P less than 0.001). Also DHT was significantly prolonged, compared with N (80 +/- 12 msec), in H1 (90 +/- 12 msec, P less than 0.01) and H2 (105 +/- 20 msec, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)