ackground : It is well known that the diastolic dysfunction of the left ventricle plays an important role in pathophysiology of heart failure in the various cardiac diseases. And many
hypertensive patients manifest diastolic dysfunction of the left ventricle in its early stage. But,
there are very few studies of right ventricular diastolic dysfunction reported, and effects of
systemic hypertension on right ventricular function are not well understood.
Thus, left ventricular diastolic dysfunction and its effects to right ventricular function need
to be evaluated in hypertensive patients.
Method : For the evaluation of the left and right ventricular diastolic function in the
hypertensive patients, 20 normotensive control subjects and 30 untreated essential hypertensive
patients were studied by pulsed doppler echocardiography at the left and right ventricular
inflow, and then E/A velocity ratio [E/A (v)], acceleration time (AT), deceleration time (DT),
and diastolic filling period (DFP) were measured after confirming normal ejection fraction by
M-mode echocardiography.
Results :
1) In the 20 normal control group, ejection fraction was 3.7±11.8% and in the 30
hypertensive patient group, it was 60.3±10.8%. There was no significant differences between
the normal control and the hypertensive patient group.
2) In the normal control group, E/A (v) of left ventricle was 1.48±0.32, E/A (v) of LV
was 0.88±1.07, mean E/A (v) of RV was 0.91±0.73. E/A (v) of LV & RV was significantly
decreased (p<0.01), compared with those of normal control group.
3) DT of left ventricle was significantly prolonged in hypertensive group (p<0.05), but
there was no significant difference in DT of right ventricle.
4) AT and DFP were significantly prolonged in right ventricle, compared with left
ventricle, but there was no significant correlation between normal control group and
hypertensive patient group.
5) Among the factors influencing the RV E/A ratio. LV E/A ratio was only significantly
correlated (r=0.538, p<0.05).
Age of subject, left ventricular ejection fraction and severity of hypertension have no
significant correlation with right and left ventricular E/A ratio.
Conclusion : The E/A ratio and deceleration time measured from pulsed doppler
echocardiogram seem to be useful parameters for evaluation of left and right ventricular
diastolic function in hypertensive patients with normal systolic function. And, right ventricular
diastolic dysfunction is closely related with left ventricular diastolic function.
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