Key result
Integrated Doppler echocardiography revealed moderate-to-severe asymptomatic diastolic dysfunction in 34% of elderly hypertensive patients, with elevated filling pressure in 58% of those with normal mitral inflow.
Why the study?
Does integrated Doppler echocardiography (TDI and PV flow) improve the detection of diastolic dysfunction and elevated filling pressure in elderly asymptomatic hypertensive patients with preserved systolic function?
Cross-Sectional (n=322)
Does integrated Doppler echocardiography (TDI and PV flow) improve the detection of diastolic dysfunction and elevated filling pressure in elderly asymptomatic hypertensive patients with preserved systolic function?
Integrated Doppler echocardiography reveals that a significant proportion of elderly asymptomatic hypertensive patients have moderate-to-severe diastolic dysfunction and elevated filling pressures despite normal mitral inflow patterns.
May support integrated Doppler evaluation in asymptomatic elderly hypertensives; hypothesis-generating and should not yet change practice.
UNLABELLED: The aim of this study was to assess the different stages of diastolic dysfunction (DD) in elderly, asymptomatic, hypertensive patients with preserved systolic function, and to investigate the role of Tissue Doppler imaging (TDI) and Pulmonary venous (PV) flow added to the routine echocardiographic assessment. Patients. 322 patients (age: 70.8+/-9.1 years) were enrolled. METHODS: Mitral inflow pattern, TDI (Ea: early diastolic velocity) and PV flow was assessed to evaluate diastolic function. Deceleration time of mitral E velocity < 150ms, E/Ea> or =7 and/or S/D< 1 of PV flow indicated elevated filling pressure (EFP). Patients were divided into four groups: no DD, mild DD, moderate DD and severe DD. RESULTS: In 63 cases we found no DD, mild DD was present in 150 cases, moderate DD in 86 cases and severe DD in 23 cases. Compared with patients without DD, the Ea was decreased in mild and moderate DD (14.8+/-2.3 vs 12.2+/-2.4 cm/s, p<0.001; vs 13.3+/-2.6 cm/s, p=0.005). Normal mitral inflow pattern was found in 149 patients, 86 of them had EFP (58%). CONCLUSIONS: One third of elderly hypertensive patients with preserved systolic function had moderate-to-severe asymptomatic DD. More than half of the patients had EFP with normal mitral inflow pattern.
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Dénes et al. (2009) conducted a cross-sectional in Hypertension with preserved systolic function (n=322). Integrated Doppler echocardiography (Tissue Doppler imaging and Pulmonary venous flow) vs. Routine echocardiographic assessment was evaluated on Stages of diastolic dysfunction and elevated filling pressure. Integrated Doppler echocardiography revealed moderate-to-severe asymptomatic diastolic dysfunction in 34% of elderly hypertensive patients, with elevated filling pressure in 58% of those with normal mitral inflow.
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