Diastolic Function Evaluation in Systemic Arterial Hypertension : A Color M-mode Doppler and Doppler Echocardiographic Analysis

ABSTRACT

BACKGROUND: Several recent studies have demonstrated that left ventricular diastolic dysfunction is major cause of congestive heart failure and may precede systolic dysfunction or without left ventricular hypertrophy in most patients with systemic arterial hypertension. The purpose of this study is to evaluate left ventricular diastolic function in patients with systemic arterial hypertension compared with normal control group using color M-mode Doppler and Doppler echocardiographic studies. METHODS: From October 1994 to August 1995. 53 patients(18 men and 35 women, mean age : 56.1±12.6 years) with essential hypertension and 30 subjects age-matched nomal controls(13 men and 17 women, mean age 55.9±12.3 years) were included in this study. We measured the early propagation slope of LV inflow by color M-mode Doppler Echocadiography and the peak velocities of E and A wave, E/A tatio, deceleration time of E wave, isovolumic relaxation time by Doppler echocardiography. We also studied left ventricular diastolic function in patients with hypertension who were divided two group(Group I : hypertension with left ventricular hypertrophy, Group II : hypertension without left vetricular hypertrophy). RESULTS: 1) Early propagation slope of LV inflow was significantly decreased in patients with hypertension compared with normal control group(57.43±17.15m/secs vs 69.87±12.71m/secs, p 0.05), whereas deceleration time of E wave was showed increasing tendency in patients with hypertension empared with normal control group(196.57±37.07m/secs vs 189.33±41.35m/secs, p>0.05). 3) Early propagation slope of LV inflow was not significantly different between Group I and Group II, but showing decreasing tendency in Group I compared with Group II(54.72±14.65m/sec vs 60.16±18.96m/sec, p>0.05). Peak velocity of E wave and peak velocity of A wave and E/A ratio and deceleration time were not significantly different between Group I and Group II but peak velocity of E wave and E/A ratio were showed decreasing tendency in Group I(0.65±0.19m/sec vs 0.73±0.22m/sec, 0.86±040 vs 1.04±0.44, p>0.05), whereas peak velocity of A wave and deceleration time of E wave were showed increasing tendency in Group I(0.80±0.20m/sec vs 0.74±0.18m/sec, 199.38±46.45m/secs vs 196.89±24.76m/secs, p>0.05). Only isovolumic relaxation time was significatly increased in Group I compared with Group II(150.63±44.75m/secs vs 120.34±19.77m/secs, p < 0.05). CONCLUSION: Left ventricular diastolic dysfunction may precrede systolic or without left ventricular hypertrophy in patients with systemic arterial hypertension. An early diagnosis of left ventricular diastolic dysfunction, color M-mode Doppler echocardiography and Doppler echocardiography were useful diagnostic stools.