Relationship Between Regional Diastolic Function and Left Ventricular Mass in Essential Hypertension

Pulsed wave tissue Doppler imaging (PTD) is an appropriate method to determine regional left ventricular (LV) diastolic function. The study was designed to evaluate regional left ventricular diastolic function and its relation with left ventricular mass in essential hypertension. For this purpose, PTD myocardial velocities (Em, Am) and velocity time integrals (VZI) of left ventricle basal and mid segment of anterior, inferior, interventricular septum and lateral wall; also mitral inflow pattern and isovolumic relaxation time (IVGZ) were evaluated at apical 2- and 4-chamber transthoracic examinations in 15 (mean ages:54(7) normal subjects, 16 hypertensive patients (mean ages: 56±8) without LV hypertrophy, 24 hypertensive patients (mean ages:58±7) with LV hypertrophy. LV mass index >125 g/m2 for men, >110 g/m2 for women was accepted as criterion for LV hypertrophy according to LV mass index calculated by the Devereux formula. Patients taking antihypertensive medications were not included in the study. Univariate analysis showed that the mitral E/A and PTD Em/Am ratios were significantly decreased in hypertension. However, when we compared the normal group with hypertensive patients without hypertrophy and with hypertrophy by using student t test, we observed that PTD Em/Am ratio in all myocardial segments significantly decreased in the presence of LV hypertrophy but only mean PTD Em velocity of lateral and anterior wall basal segments were significantly different in the absence of LV hypertrophy. These findings suggest that regional LV diastolic functions of hypertensive patients without LV hypertrophy are more pronouncedly deteriorated in the anterior and lateral basal segments but deterioration of regional diastolic function occurs uniformly in all myocardial segments if an obvious LV hypertrophy is present.