Doppler left ventricular filling characteristics in hypertensive left ventricular hypertrophy

Impaired left ventricular filling in presence of normal systolic function 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/m2 were compared with 14 age-and sex-matched normals. Compared to normal values, all Doppler left ventricular filling parameters were significantly 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 isovolumic relaxation period (74 ± 6 vs. 121 ± 20 ms, p < 0.0001), respectively. Acceleration time of the early filling velocity did not show any significant difference. Abnormal isovolumic relaxation period was found to be significantly (p < 0.005) more prevalent in this group of hypertensive patients compared to other left ventricular filling parameters. We conclude that isovolumic relaxation period is the most common abnormality in patients with hypertensive left ventricular hypertrophy compared to the other commonly used Doppler left ventricular filling parameters.