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Doppler echocardiographic evaluation of the spectrum of left ventricular diastolic dysfunction in essential

J F Ren1, S B Pancholy, A S Iskandrian

  • 1Cardiac Ultrasound Laboratory, Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104.

American Heart Journal
|April 1, 1994
PubMed

Insights

Essential hypertension can cause left ventricular (LV) concentric hypertrophy and remodeling. Early signs of hypertensive heart disease include decreased peak filling rate, even with normal systolic function.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Hypertension Research

Background:

  • Essential hypertension is a major risk factor for cardiovascular disease.
  • Hypertensive heart disease involves structural and functional changes in the left ventricle.
  • Understanding early cardiac alterations is crucial for timely intervention.

Purpose of the Study:

  • To investigate left ventricular (LV) topography and diastolic/systolic functions in patients with essential hypertension.
  • To characterize the patterns of LV remodeling and hypertrophy in hypertensive individuals.
  • To identify early functional changes in the hypertensive heart.

Main Methods:

  • Doppler echocardiography was used to assess LV structure and function.
  • 41 patients with essential hypertension (group 1) and 33 age-matched controls (group 2) were studied.
  • Left ventricular volumes, mass index (LVMI), and early diastolic filling parameters were analyzed.

Main Results:

  • 54% of hypertensive patients showed LV concentric hypertrophy, 19% combined hypertrophy with eccentric remodeling, and 27% concentric remodeling.
  • LV systolic function remained normal across hypertensive subgroups.
  • Decreased peak filling rate (NPFR) was observed in concentric hypertrophy and combined remodeling, correlating inversely with LVMI (r = -0.89, p < 0.0001).
  • Concentric remodeling showed decreased end-diastolic volume but normal NPFR.

Conclusions:

  • Left ventricular concentric hypertrophy, with or without remodeling, is prevalent in essential hypertension.
  • A reduced peak filling rate is an early indicator of hypertensive heart disease, preceding systolic dysfunction.
  • Doppler echocardiography effectively detects early diastolic dysfunction in hypertension.

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