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Left Ventricular Diastolic Dysfunction in Patients With Hypertension and Preserved Systolic Function

      Objective

      To assess prospectively diastolic function in hypertensive patients with preserved left ventricular function, particularly focusing on the limitation of the transmitral flow velocity curve alone to detect diastolic dysfunction.

      Patients and Methods

      Comprehensive Doppler analysis was performed in 51 hypertensive patients with preserved left ventricular systolic function.

      Results

      The ratio of the peak early diastolic filling wave velocity to the peak velocity of filling wave at atrial contraction was less than the age-adjusted mean value minus 2 SD in 16 patients, and the other 35 patients had a “normal” transmitral Doppler signal. However, the combined transmitral and pulmonary venous Doppler analysis revealed that 12 of these 35 patients had a “pseudonormal” pattern. The prevalence of diastolic dysfunction was estimated at 31% with use of transmitral Doppler alone but increased to 55% when comprehensive Doppler analysis was used (P<.05).

      Conclusion

      The presence of diastolic dysfunction has been frequently overlooked in hypertensive patients with transmitral Doppler analysis alone, and an assessment of diastolic function with a comprehensive Doppler analysis is needed in patients at risk for diastolic dysfunction.
      E/A (ratio of peak mitral early diastolic and atrial contraction velocities), EF (ejection fraction), LV (left ventricular)
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