Characterization of left ventricular diastolic function in hypertension by use of Doppler tissue imaging and color M-mode techniques.
BACKGROUND
Abnormalities in left ventricular (LV) relaxation and/or increased filling pressures are indicators of LV diastolic dysfunction in patients with hypertension (HTN). The purpose of this study was to assess clinical use of pulsed wave Doppler, Doppler tissue imaging (DTI), and color M-mode (CMM) indices for determination of diastolic function in patients with HTN.


METHODS
In all, 278 ambulatory patients with normal LV systolic function were grouped according to the presence of HTN with and without LV hypertrophy (LVH) (determined by the 2-dimensional area-length method) as follows: healthy control subjects (NC, n = 122), HTN without LVH (HTN, n = 70), and HTN with LVH (HTN+LVH, n = 86). Pulsed wave Doppler-derived measurements included transmitral E- and A-wave velocities, E/A ratio, and deceleration and isovolumic relaxation time intervals; DTI-derived early diastolic (Em) velocities were obtained at 4 LV annular sites. CMM-derived flow propagation velocity and the intraventricular pressure gradient were also calculated. Analysis of covariance adjusted for age and sex of diastolic indices was performed to compare the differences among groups.


RESULTS
Only DTI-derived filling pressures demonstrated progressive statistically significant differences among all 3 groups (ie, HTN vs NC, HTN+LVH vs NC, and HTN vs HTN+LVH). However, CMM-derived flow propagation velocity and intraventricular pressure gradient indices were similar among the groups.


CONCLUSIONS
DTI is a robust method compared with pulsed wave Doppler- and CMM-derived indices for the quantitative assessment of LV relaxation and filling pressures in patients with HTN.
Rovner
Aleksandr
A
Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri 63110, USA.
de las Fuentes
Lisa
L
Waggoner
Alan D
AD
Memon
Nada
N
Chohan
Rizwana
R
Dávila-Román
Victor G
VG
D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology