Study on left ventricular diastolic function in essential hypertension and coronary heart disease by color M-mode Doppler echocardiography

Objectives To investigate diastolic dysfunction in essential hypertension (EH) and coronary artery disease (CAD) using color M mode Doppler echocardiography and to compare with conventional methods; also to investigate diastolic function under normal systolic function and systolic dysfunction and pseudo normalization phenomena so that we can diagnose patients' functional class and treat patients. Methods We prospectively studied 36 normal subjects (group Ⅰ), 74 subjects with essential hypertension (group Ⅱ) and 33 subjects with coronary artery disease (group Ⅲ) by color Doppler echocardiography. Peak early and late transmitral flow velocity (E and A velocities), the ratio of early to late peak veloci ties (E/A) and duration of late transmitral flow velocity (AD) were obtained. Systolic (S), diastolic (D) flow, atrial reversal (Pva), atrial reversal duratio (Pvad) of pulmonary vein were measured. The rate of propagation of peak early filling flow velocity (Vp), time delay (TD) of the peak early filling flow velocity from mitral tips to the apex and Vp/E by color M mode Doppler echocardiography. Results Three groups were not statisticaly different in gender, age and heart rate. According to EF, patients in CAD group and EH group were divided into two groups, EF≤60% group (systolic dysfunction group) and EF60% group (normal systolic function group). Almost all parameters of diastolic function in patients with systolic dysfunction showed no significant differences from that in patients with normal systolic function but there were differences of Vp, TD and Vp/E ratio between the two groups, reaching the statistical significance. There were 10 patients who had systolic dysfunction (EF≤60%) while E/A ratio(1)was normal (pseudonormalization). The result showed significant difference in Vp, TD and Vp/E between pseudonormal group and control group ( P0 01 ), while other parameters on diastolic function had no significance. Conclusions ①There is diastolic dysfunction in patients with essential hypertension and coronary artery disease. ②The rate and time of propagation of peak early filling flow velocity (Vp, TD and Vp/E) by M mode color Doppler echocardiography are more precise and reliable parameters to evaluate LV diastolic function. They are capable of distinguishing pseudonormalized transmitral flow pattern, and assess the characteristic of diastolic dysfunction in patients with systolic dysfunction in essential hypertension and coronary artery disease.