TY - JOUR
T1 - Limited atrial compensation to reduced early diastolic filling in hypertensive patients with advanced left ventricular hypertrophy
T2 - A Doppler echocardiographic study
AU - Kitabatake, Akira
AU - Tanouchi, Jun
AU - Masuyama, Tohru
AU - Fujii, Kenshi
AU - Ishihara, Ken
AU - Uematsu, Masaaki
AU - Ito, Hiroshi
AU - Yoshida, Yutaka
AU - Hori, Masatsugu
AU - Inoue, Michitoshi
AU - Kamada, Takenobu
PY - 1989/3/1
Y1 - 1989/3/1
N2 - 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.
AB - 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.
KW - Atrial function
KW - Left ventricular filling
KW - Left ventricular hypertrophy
KW - Ventricular diastolic function
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U2 - 10.1007/BF02058356
DO - 10.1007/BF02058356
M3 - Article
C2 - 2531139
AN - SCOPUS:0024470637
VL - 5
SP - 33
EP - 40
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 1
ER -