Doppler Tissue Imaging Is More Sensitive Than Other Echocardiographic Markers in Identifying Abnormal Relaxation in Subclinical Hypertensive Disease and Normal Ejection Fraction

Abstract

This report describes the use of echocardiographic measurements for the assessment of left ventricular diastolic function in two young patients with newly diagnosed hypertension. Measurements for the assessment of left ventricular relaxation and filling pressures included mitral inflow, Doppler tissue imaging (DTI), color M-mode propagation velocity slope, and the isovolumic relaxation time. The mitral inflow, propagation velocity, and isovolumic relaxation time measurements were all within normal limits; however, DTI measurements of the E′ velocity at the septal and lateral annulus were significantly reduced in both patients. Further visual inspection demonstrated discrete proximal septal wall thickening that is thought to be modulated by pressure loading (i.e., increased afterload due to hypertension) and ejection. These findings may represent a “transitional state” of early ventricular remodeling and organ failure in the development of hypertensive disease. In summary, DTI appears to be more sensitive compared to other markers in identifying abnormal relaxation in subclinical hypertensive disease and normal ejection fraction.