Systo-diastolic ventricular function in patients with hypertension: an echocardiographic tissue doppler imaging evaluation study.
BACKGROUND
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects.


METHODS
We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched for age, sex, heart rate, smoking status and body surface area.


RESULTS
There were no significant differences in ventricular diameters, volumes, shortening and ejection fraction values; TDI showed a progressive systolic wave peak reduction from Group A to B and from Group B to C. Routinely Doppler diastolic function did not show any significant difference between Group A and B; TDI showed progressive E wave peak velocity decrease and A wave peak velocity increase from Group A to B and C and from Group B to C.


CONCLUSIONS
TDI evaluation showed a ventricular systolic dysfunction in pts with hypertensive cardiomyopathy; in addition, an early mild systo-diastolic dysfunction was detected in subjects with hypertension but no evidence of hypertensive cardiomyopathy.
Leggio
Massimo
M
Cardiovascular Department, Cardiac Rehabilitation Operative Unit (S.I.), San Filippo Neri Hospital, Via della Lucchina 41, Rome 00135, Italy. mleggio@libero.it
Sgorbini
Luca
L
Pugliese
Marco
M
Mazza
Andrea
A
Bendini
Maria Grazia
MG
Fera
Maria Stella
MS
Giovannini
Ezio
E
Leggio
Francesco
F
D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D018619:Echocardiography, Doppler, Pulsed; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009929:Organ Size; D013318:Stroke Volume; D013599:Systole; D016276:Ventricular Function