title: Doppler echocardiographic evaluation of the spectrum of left ventricular diastolic dysfunction in essential hypertension.
abstract: Left ventricular topography and diastolic and systolic functions were studied in 41 patients with essential hypertension (group 1) and 33 age-matched normal adults (group 2) by Doppler echocardiography. In group 1 54% had LV concentric hypertrophy, 19% had combined concentric hypertrophy and eccentric remodeling, and 27% had concentric remodeling. LV systolic function was within the normal range. In concentric LV remodeling, the EDV was significantly decreased (compared with group 2) (84 +/- 15 vs 130 +/- 38 ml, p < 0.05), whereas the NPFR was normal (2.89 +/- 0.65 vs 3.22 +/- 0.83 sec-1, p = NS). In concentric hypertrophy, LV end-diastolic and end-systolic volumes were normal, but the NPFR was decreased (2.04 +/- 0.59 sec-1). Patients with concentric hypertrophy and eccentric remodeling had the largest end-diastolic (140 +/- 48 ml) and end-systolic (62 +/- 32 ml) volumes and the lowest NPFR (1.67 +/- 0.69 sec-1). The LVMI inversely correlated with the NPFR (r = -0.89, p < 0.0001). Thus LV concentric hypertrophy with or without concentric or eccentric remodeling is seen in patients with systemic hypertension. A decrease in peak filling occurs early in the evolution of hypertensive heart disease and is observed even when systolic performance is still normal.
authors.affiliation: Cardiac Ultrasound Laboratory, Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104.
authors.forename: J F
authors.initials: JF
authors.lastname: Ren
authors.forename: S B
authors.initials: SB
authors.lastname: Pancholy
authors.forename: A S
authors.initials: AS
authors.lastname: Iskandrian
authors.forename: G W
authors.initials: GW
authors.lastname: Lighty
authors.forename: C
authors.initials: C
authors.lastname: Mallavarapu
authors.forename: B L
authors.initials: BL
authors.lastname: Segal
mesh_terms: D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013599:Systole; D016277:Ventricular Function, Left