IMPAIRED LEFT-VENTRICULAR FILLING IN BORDERLINE HYPERTENSIVE PATIENTSWITHOUT CARDIAC STRUCTURAL-CHANGES

To determine the effect of borderline hypertension on left ventricular diastolic performance, 16 patients with borderline hypertension who d id not have left ventricular hypertrophy and 16 age-sex-matched patien ts with normotension of similar age and body mass index were investiga ted. Pulsed Doppler echocardiography was used to record left ventricul ar filling signals at rest and immediately after supine ergometer exer cise. All subjects had normal left ventricular structure and systolic function. At rest the borderline hypertension group in comparison with the normotension group had a depressed peak velocity of early filling (E) (44 +/- 7 vs 54 +/- 10 cm/sec; p < 0.01), no enhanced peak veloci ty of late filling (A) (52 +/- 8 vs 50 +/- 11 cm/sec; not significant) , and a reduced E/A ratio (0.9 +/- 0.2 vs 1.1 +/- 0.3; p < 0.05). Atri al filling time and preejection period were similar in the two groups. The effect of exercise on left ventricular filling velocity in patien ts with borderline hypertensive resembled that in those with normotens ion. Percentage changes in E (+14% +/- 12% vs +14% +/- 13%) and A (+13 % +/- 8% vs 11 % +/- 12%) were equivalent, suggesting a preserved dias tolic reserve for exercise in the borderline hypertension group. In co nclusion, borderline hypertension appears to be predictive of early fi lling impairment, and a late filling compensative mechanism is not yet apparent. These findings in borderline hypertension without apparent cardiac damage call for clinical attention to prevent further deterior ation in cardiac function.