Limited atrial compensation to reduced early diastolic filling in hypertensive patients with advanced left ventricular hypertrophy: A Doppler echocardiographic study

Akira Kitabatake, Jun Tanouchi, Tohru Masuyama, Kenshi Fujii, Ken Ishihara, Masaaki Uematsu, Hiroshi Ito, Yutaka Yoshida, Masatsugu Hori, Michitoshi Inoue, Takenobu Kamada

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

To assess atrial contribution to left ventricular (LV) filling in hypertension, we studied, using pulsed Doppler echocardiography, 22 hypertensive patients without apparent LV hypertrophy (LVH), 12 hypertensive patients with LVH, and 24 age-matched normal subjects. From mitral flow velocity waveform, we determined peak velocity of early diastolic filling flow (peak E), peak velocity of late diastolic filling flow (peak A), and the peak A/peak E ratio (peak A/peak E). Peak E decreased in hypertensives without apparent LVH and showed a further decrease in hypertensives with LVH compared with normal subjects (57±8 [mean ± SD];P<0.001, 46±7;P<0.0001, vs 65±10 cm/s). On the other hand, peak A/peak E increased in hypertensives without apparent LVH, and greatly increased in hypertensives with LVH (1.06±0.14;P<0.001, 1.40±0.29;P<0.0001, vs 0.79±0.21). However, increased peak A was not significantly different between the hypertensive groups (60±8 vs 64±8; NS, both;P<0.001 vs 50±10 cm/s for normal subjects). In hypertensives, we found no significant correlation between peak A and the wall thickness index (WTI, determined as mean LV wall thickness normalized by LV diastolic dimension), whereas peak E was significantly correlated with WTI (r=-0.65;P<0.001). Our findings indicate that atrial contraction can not fully compensate the decrease in early diastolic filling caused by advanced LVH. We conclude that atrial compensation for reduced early diastolic filling is limited in hypertensive patients with advanced left ventricular hypertrophy.

Original languageEnglish
Pages (from-to)33-40
Number of pages8
JournalHeart and Vessels
Volume5
Issue number1
DOIs
Publication statusPublished - Mar 1 1989
Externally publishedYes

Keywords

  • Atrial function
  • Left ventricular filling
  • Left ventricular hypertrophy
  • Ventricular diastolic function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kitabatake, A., Tanouchi, J., Masuyama, T., Fujii, K., Ishihara, K., Uematsu, M., Ito, H., Yoshida, Y., Hori, M., Inoue, M., & Kamada, T. (1989). Limited atrial compensation to reduced early diastolic filling in hypertensive patients with advanced left ventricular hypertrophy: A Doppler echocardiographic study. Heart and Vessels, 5(1), 33-40. https://doi.org/10.1007/BF02058356