ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN ELDERLY HYPERTENSIVE PATIENTS

Background This study was undertaken to determine the effects of agein g and hypertension on left ventricular diastolic function using Dopple r echocardiography. Methods Eighteen hypertensive elderly patients (me an age 75 years) with systolic blood pressure greater than or equal to 160 mmHg and/or diastolic blood pressure greater than or equal to 90 mmHg were included. Nineteen healthy young subjects (mean age 32 years ) and 37 healthy elderly subjects (mean age 74 years) served as compar ison groups. Two-dimensionally guided M-mode echocardiographic tracing s and Doppler echocardiographic examination of transmitral flow veloci ty were performed. Results Left ventricular mass index (LVMI) in healt hy elderly subjects (104.5 +/- 29.7 g/m(2)) was not significantly high er than in healthy young subjects (100.6 +/- 25.7 g/m(2), P > 0.05), T he peak mitral early velocity (55.3 +/- 11.9 cm/s) was lower and peak atrial velocity (69.7 +/- 13.7 cm/s) was higher in healthy elderly sub jects than in the healthy young group (66.8 +/- 11.4 and 43.2 +/- 15.4 cm/s, P < 0.05), The hypertensive elderly group had higher LVMI (153. 1 +/- 40.5 g/m(2)) than in the healthy elderly group (P < 0.05). Left atrial size index was significantly increased in the hypertensive elde rly group compared with the healthy elderly group (26.1 +/- 2.4 versus 23.1 +/- 3.7 mm/m(2), P < 0.05). The peak mitral atrial velocity in t he hypertensive elderly patients (79.4 +/- 5.6 cm/s) was significantly greater than in the healthy elderly group (P < 0.05). Conclusions Thi s study demonstrates a minimal increase in LVMI with ageing, and a dra matic age-related change in diastolic function as measured by diastoli c filling. Our study also shows that hypertensive elderly patients hav e increased LVMI and left atrial size, and impaired diastolic filling.