Doppler Evaluation of Left Ventricular Diastolic Filling in Patient with Hypertension

To study left ventricular diastolic filling in patient with hypertension in different form of left ventricular hypertrophy(LVH), 105 patients with hypertension and 30 normal persons underwent M-mode echocardiography and pulsed Doppler measurement of the left ventricular inflow. From the M-mode echocardiographic measurement of left ventricular dimension, hypertensive patients were subdivided into three grouops : group I(n=27) ; no LVH, group II(n=36) ; concentric LVH, grooup III(n=42) asymmetric septal hypertrophy. From the digitized trace of the pulsed Doppler at the mitral valve level, Doppler diastolic time intervals, peak velocities at rapid filling (E velocity) and atrial contraction(A velocity) and the triangle area under the A velocity(A area) and triagle area under the E velocity(E area) were measured. The peak A velocity(normal subjects ; 0.51±0.08m/sec, group I ; 0.73±0.14m/sec, group II ; 0.78±0.15m/sec, group III ; 0.8±0.23 m/sec) and the A area(noral subjects ; 4.71±1.64, group I; 6.24±1.78, group II ; 7.75±2.93, group III ; 8.05±3.11) and the peak A/E velocity ratio and the A/E area ratio were significantly different from the normal controls(P<0.01).

The peak E velocity(normal subjects ; 0.76±0.13, group I ; 0.7±0.12, group II ; 0.63±0.12, group III ; 0.59±0.15m/sec) and E area (normal subjects ; 9.61±2.8, group I ; 8.11±2.13, group II ; 7.82±2.73, group III ; 7.34±3.07) were significantly different between hypertensive groups with LVH and normal controls. Doppler time intervals, total area were not different between groups.

This study shows that abnormal pattern of left ventricular diastolic filling occur in patients with hypertension and the peak A velocity and the peak A/E velocity ratio and the peak A/E area ratio are the earliest findings that can detectable by Doppler echocardiography.