DOPPLER LEFT-VENTRICULAR FILLING CHARACTERISTICS IN HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY

Impaired left ventricular filling in presence of normal systolic funct ion is known to cause heart failure in patients with hypertensive left ventricular hypertrophy. To evaluate which of the Doppler parameters best detect diastolic abnormalities, 24 patients with hypertension and left ventricular hypertrophy with mean +/- SD blood pressures of 163 +/- 17/102 +/- 7 mm Hg and left ventricular mass 150 +/- 26 g/m(2) wer e compared with 14 age-and sex-matched normals. Compared to normal val ues, all Doppler left ventricular filling parameters were significantl y altered in hypertensive patients with left ventricular hypertrophy, i.e. deceleration time of early velocity (146 +/- 14 vs. 185 +/- 34 ms , p < 0.0005), ratio of late (A) and early (E) peak filling velocities (0.74 +/- 0.16 vs. 1.30 +/- 0.40, p < 0.0001), ratio of the integrals of A and E (0.50 +/- 0.16 vs. 0.90 +/- 0.47, p < 0.01), and isovolumi c relaxation period(74 +/- 6 vs. 121 +/- 20 ms, p < 0.0001), respectiv ely. Acceleration time of the early filling velocity did not show any significant difference. Abnormal isovolumic relaxation period was foun d to be significantly (p < 0.005) more prevalent in this group of hype rtensive patients compared to other left ventricular filling parameter s. We conclude that isovolumic relaxation period is the most common ab normality in patients with hypertensive left ventricular hypertrophy c omapred to the other commonly used Doppler left ventricular filling pa rameters.