Assessment of diastolic dysfunction in elderly hypertensive patients using integrated Doppler echocardiography

摘要

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/Ea2:7 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+-2.4cm/s, p<0.001; vs. 13.3+-2.6cm/s, ?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.