Doppler Assessment of the Effects of Isometric Stress on Left Ventricular Filling in Hypertensive Young Adults

Doppler interrogation at the in-flow of the left ventricle was used to test the effects of isometric stress on ventricular filling in 7 hypertensive subjects with mild to moderate left ventricular hypertrophy, aged forty-two +/- seven years, compared with 9 matched healthy control males. In the hypertensive patients at rest, peak early diastolic (E) velocity was lower, and atrial (A) velocity higher, with lower E/A peak velocity ratios than in normals (p less than 0.05). These differences were more accentuated during isometric stress. Atrial filling fractions were higher in hypertensives (37 +/- 6%) than in normals (24 +/- 7%) at rest, p less than 0.05, and this difference increased during isometric stress (44 +/- 9% versus 30 +/- 11%). Thus, isometric stress accentuated the reliance of left ventricular filling on atrial contribution and may be applied for the detection of early ventricular filling abnormalities in patients with mild hypertension. The systolic blood pressure and the hypertrophic process were both important determinants of left ventricular diastolic filling.