Analysis of the Doppler Pulmonary Flow Velocity and Mitral Flow Velocity Pattern in Hypertensive Hearts

Objectives

Hypertension provokes left ventricular diastolic dysfunction due to decreased elasticity of the ventricular myocardium at first. It has been proposed that the Doppler echocardiography might provide information concerning diastole because of its ability to measure the blood flow velocities across the mitral valve noninvasively. But Doppler mitral velocity may be "normalized" in hypertensive patients in different conditions. The purpose of this study is to evaluate diastolic function in hypertensive hearts using Doppler echocardiography of the pulmonary venous flow in conjunction with mitral flow velocity pattern.

Methods

We measured the mitral flow velocity curves and the pulmonary flow velocity curves in fifty hypertensive patients(mean age : 56.3±10.0, man : 19, woman : 31) nad forty healthy adults(mean age : 51.6±12.5, man : 14, woman : 26) from March 1995 to December 1995 by using the SONO 1000 of Hewlett Packerd.

Results

1) The mitral flow velocity pattern in 50 hypertensive patients was characterized by the decrease in the peak early diastolic filling velocity(E : 0.59±0.12m/sec) and the ratio of E to peak filling velocity(A : 1.00±0.46m/sec). Isovolumetric relaxation time and deceleration time were 127.2±33.3msec, 258.9±40.9msec respectively. They were longer than normotensive patients(P < 0.05).

2) The pulmonary venous flow velocity pattern in hypertensive patients was characterized by the decreased peak diastolic forward velocity(D : 33.7±9.8cm/sec) and the ratio of peak systolic forward velocity(S) to D(S/D : 1.60±0.5)(P < 0.05).

3) There was no relation between the flow velocity integral parameters and the peak flow velocity parameters of pulmonary venous flow pattern in hypertensive patients.

4) The dofference in the pulmonary venous duration and the mitral A wave duration at atrial contraction (DA-DR) was 20.9±29.4 msec in hypertensive patients. DA-DR in normatensive patients was 24.3±32.9msec. DA-DR was not significant in hypertensive patients compared with that of the healthy subjects (P < 0.05)

Conclusion

Analysis of pulmonary venous flow velocity pattern in conjunction with mitral flow velocity pattern in hypertensive patients provides more accurate assessment of left ventricular diastolic function.