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European Heart Journal 1989 10(7):611-621;
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Myocardial hypertrophy and left ventricular diastolic function in hypertensive patients: an echo Doppler evaluation

D. BONADUCE, R. BREGLIO, G. CONFORTI, N. DE LUCA, M. VITTORIA MONTEMURRO, P. ARRICHIELLO and M. PETRETTA

Institute of Internal Medicine, Cardiology and Heart Surgery, 2nd School of Medicine Naples, Italy

Received 19 July 1988; revised 6 January 1989; .

Address for correspondence and reprints: Domenico Bonaduce, Via Aniello Falcone 394, 80127, Napoli, Italy

Abstract

The presence and the characteristics of left ventricular diastolic dysfunction in mild to moderate systemic hypertension were evaluated in 13 normotensive subjects (Group I), in 12 hypertensive subjects without (Group II) and 28 with (Group III) LV hypertrophy who underwent two-dimensional Doppler echocardiographic study. Among Group III patients, a subset (n = 12) with a dilated left ventricle was identified. Diastolic filling parameters were impaired in Group III patients while, in Group II, they were intermediate between Groups I and III. In all Group III patients normalized peak filling rate (nPFR) correlated directly with mean velocity of circumferential fibre shortening (mVCF) (r=0·55; P<0·001) and inversely with left ventricular mass index (LVM) (r=–0·60; P<0·001), left ventricular end-diastolic diameter (LVIDd) (r= –0·63; P<0·001), LV peak systolic stress (LVWST) (r=– 0·64; P < 0·01). A separate analysis showed that these correlations were also present in patients without left ventricular dilation; in the subset with left ventricular dilation nPFR correlated only with LVWST (r= –0·73;P<0·01), but not with LVM, m VCF, L VIDd.

Thus, left ventricular hypertrophy is one of the major determinants of diastolic dysfunction in hypertensives; other factors influence nPFR values in hypertensive patients when the left ventricle dilates.

Key Words: Hypertension • echo Doppler • diastolic filling


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