Echocardiographic assessment by computer-assisted analysis of diastolic left ventricular function and hypertrophy in borderline or mild systemic hypertension

Abstract

Systemic hypertension is a common cause of congestive heart failure. However, left ventricular (LV) systolic function remains normal for many years in patients with mild or moderate hypertension. In this study, high-quality M-mode echocardiograms were recorded in 7 patients with borderline hypertension, 14 patients with mild hypertension and 15 normal persons. Measures of systolic and diastolic LV function and the degree of LV hypertrophy were studied with the assistance of a tablet digitizer and dedicated microcomputer. Average blood pressure was 125 ± 10/77 ± 7 mm Hg in normal subjects, 146 ± 18/92 ± 2 mm Hg in patients with borderline hypertension and 150 ± 11/102 ± 4 in patients with mild hypertension. Indexes of systolic LV function were similar in all 3 groups. The peak rate of early relaxation of the LV posterior wall was significantly decreased in the group of patients with mild hypertension (4.7 vs 6.6 sec −1, p < 0.01). The mitral valve closure rate was 150 ± 32 mm/s in normal subjects, 119 ± 35 mm/s in patients with borderline hypertension and 106 ± 26 mm/s (p < 0.001) in patients with mild hypertension. Mild LV hypertrophy was present in 6 of 7 patients with borderline and 13 of 14 patients with mild hypertension. The degree of hypertrophy and the level of blood pressure correlated poorly. It is concluded that subtle abnormalities of diastolic LV function may be present in patients with mild hypertension at a time when LV systolic function in normal and that the degree of hypertrophy and intermittent measurements of blood pressure at rest correlated, poorly, suggesting that additional factors may play a role.