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PubMed1990

Doppler echocardiographic evaluation of left ventricular function.

Invasive measurements of maximum acceleration of aortic blood flow are sensitive indicators of left ventricular function. Doppler echocardiography provides noninvasive measurements of aortic blood flow acceleration. Our studies establish the accuracy of Doppler-derived indices of aortic blood flow velocity for evaluation of left ventricular function. Doppler-derived peak velocity and mean acceleration showed excellent correlation with invasively measured peak left ventricular dP/dt and maximum aortic blood flow (dQ/dt) under varying heart rate, preload, afterload, and inotropic states. Similar correlations were observed between Doppler-derived peak velocity and mean acceleration and invasively measured left ventricular dP/dt and dQ/dt under conditions of varying degrees of myocardial ischemia. Thus, Doppler echocardiography provides an accurate noninvasive method to evaluate left ventricular performance.

Animals↗

PubMed1993

[Effect of dynamic cardiomyoplasty on the left ventricular function and hemodynamics in chronic canine models].

This study was undertaken to examine the effect of cardiac assist and left ventricular function after dynamic cardiomyoplasty (DCMP). In the first group (GI) of 10 mongrel dogs DCMP was drived immediately after wrapping both ventricles by latissmus dorsi muscle flap (LDMF). In the second group (GII) of 10 mongrel dogs DCMP was derived over 6 weeks after production of DCMP for achievement of complete adhesion between LDMF and myocardium. In the both groups, aortic pressure, cardiac output, left ventricular systolic pressure, and ejection fraction of the left ventricle were significantly increased by DCMP driving (p < 0.001). But left ventricular systolic pressure was remarkably increased in GII compared with that of GI (21.2 +/- 10.2% versus 14.0 +/- 9.6%, p < 0.001), and end diastolic pressure of the left ventricle was apparently decreased in GII (61.6 +/- 42.3% p < 0.05). Thus, satisfactory results were recognized that cardiac assist for left ventricular function was enhanced after completion of adhesion between myocardium and LDMF. Echocardiography in GII demonstrated that left ventricular systolic dimention was significantly decreased from 33.8 +/- 1.0 mm to 27.6 +/- 1.2 mm (p < 0.001). Thus, left ventricular fractional shortening was significantly increased from 24.0 +/- 2.4% to 38.0 +/- 2.6% (p < 0.001). However, left ventricle end-diastolic dimention was not changed even during DCMP driving. So disturbance in left ventricular function during diastole could not be recognized. In conclusion, especially after adhesion of both muscles of LDMF and myocardium, effect of cardiac assist was remarkably enhanced, and disturbance of diastolic function of the left ventricle could not be observed.

Animals↗

PubMed1988

Histology of the postischaemic myocardium and its relation to left ventricular function.

The relation between the histology of the myocardium and left ventricular function was studied in 23 dogs submitted to 90 min of coronary artery occlusion followed by reperfusion for up to 1 week. It was shown that 32% of the perfusion area of the occluded coronary artery was irreversibly damaged. There was, however, no significant correlation between the decrease in left ventricular function (ejection fraction assessed by angiography) and the extent of myocardial necrosis. Upon reperfusion, salvage of 68% of the perfusion area of the occluded vessel was obtained. Viability of the myocardium in this area was demonstrated by electron microscopy. However, postischaemic regional function was completely lost in the first 24 h, in spite of this considerable amount of viable tissue. Nevertheless, regional function recovered after 1 week of reperfusion, which suggests a stunned myocardium in the early postischaemic phase. These results show that histological examination of postischaemic tissue has prognostic value in terms of recovery of function, but a direct correlation between structure and function does not exist in the early reperfusion phase.

Actin Cytoskeleton↗

PubMed1993

[Left ventricular function during symptomatic and asymptomatic myocardial ischemia].

Transluminal coronary angioplasty (PTCA) causes transient occlusion of the coronary artery and temporary ischemia of the left ventricle. Left ventricular dysfunction during silent and symptomatic episodes of myocardial ischemia during PTCA was evaluated continuously with a newly developed miniature, non-imaging scintillation probe. Parameters of left ventricular function were compared before and during balloon inflations of 60 s duration: ejection fraction (EF), indices of end-systolic and end-diastolic volumes (ESV, EDV), peak ejection and peak filling rates (PER, PFR). 13 patients (age 54 +/- 7.4 years) were symptomatic, 10 patients (age 61 +/- 8 years) were asymptomatic. Impairment of left ventricular function during ischemia did not show any significant differences between the symptomatic and asymptomatic patients. It is therefore concluded that symptomatic and asymptomatic episodes of myocardial ischemia during PTCA cause similar impairment of systolic and diastolic left ventricular function. The degree of left ventricular dysfunction during PTCA cannot be estimated on the basis of clinical symptoms.

Aged↗

PubMed2000

Reperfusion syndrome: relationship of coronary blood flow reserve to left ventricular function and infarct size.

OBJECTIVES: We tested the hypothesis that the reperfusion syndrome (RS), defined as an additional elevation of the ST segment upon reperfusion, may be a marker of microcirculatory reperfusion injury during acute myocardial infarction (AMI). BACKGROUND: The pathophysiology of the RS is unknown, and its prognostic implications are controversial. METHODS: Twenty-one patients with an anterior AMI treated < or =12 h after onset by primary coronary angioplasty (PTCA) were studied. Coronary velocity reserve (CVR), an index of microcirculatory function, was measured using a Doppler guidewire. Left ventricular (LV) ejection fraction, infarct size (percent defect) and LV end-systolic volume index (LVESVi) were evaluated by radionuclide ventriculography, 201T1 single-photon emission computed tomography and contrast ventriculography, respectively. RESULTS: Baseline ST elevation and pain-to-TIMI 3 time were similar in patients with and without RS. Patients with RS (10/21) had a lower post-PTCA CVR than patients without RS (median [95% confidence interval]: 1.2 [1-1.3] vs. 1.6 [1.5-1.7], p < 0.005). Even though predischarge CVR was similar in the two groups, infarct size at six weeks (26 [21 to 37] vs. 14 [10-17]% 201T1 defect, p = 0.001) and predischarge LVESVi (45% [40 to 52] vs. 30% [29 to 38] mL/m2, p = 0.001) were larger, and LV ejection fraction at six weeks (40% [37 to 46] vs. 55% [50 to 60], p = 0.004) was lower in patients with RS than in patients without RS. CONCLUSIONS: Patients with RS during primary PTCA for an anterior AMI have a transiently lower CVR than patients without RS, but sustained LV dysfunction and larger infarct size, suggesting that RS is a marker of microcirculatory reperfusion injury.

Aged↗

PubMed1991

Survival in patients with depressed left ventricular function treated by implantable cardioverter defibrillator.

Mortality in patients with cardiovascular disease is generally due to pump failure or lethal ventricular arrhythmias. In patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) and poor left ventricular (LV) function the death rate is particularly high. The overall incidence of premature arrhythmic death rate in patients with poor LV function is not totally clear. Since implantable cardioverter defibrillator (ICD) could prevent arrhythmic death in any population, we proceeded to analyze mortalities in patients with poor LV function who received ICD. Among a total of 200 consecutive patients receiving ICD at our institution, 68 (34%) had LV ejection fraction (LVEF) of less than 30%. Thirty-one of these (45%) experienced appropriate ICD discharges and 17/31 (55%) had multiple shocks. Survival curves in this population revealed a 5 year projected overall survival of 11% whereas an actual survival was 60%. Even those who ultimately died from nonsudden causes, life was prolonged by ICD in a significant number of cases. Based upon these findings it is concluded that ICD has a major impact on survival in patients with poor LV function suggesting that many of these patients die prematurely from arrhythmia causes.

Actuarial Analysis↗

PubMed1999

[Using the internal thoracic artery of patients with reduced left ventricular function].

Todate internal mammary artery (IMA) is routinely used in coronary artery bypass grafting even in elder patients. However in patients with poor left ventricular function use of the IMA is discussed controversely in Germany. Main arguments against IMA are an increased operation time, initially lower blood flow, higher rates of reoperation for bleeding and more perioperative complications. In this study we investigated use of the IMA in patients with poor left ventricular function (LVEF < 40%) compared to exclusively veingraft bypass surgery. 137 patients (105 m/32 f) suffering from coronary artery disease with reduced LVEF (12-40%) were randomized in the study. 67 patients received exclusively vein grafts (group I), 70 patients routinely obtained an IMA graft. Criteria used for evaluation of IMA graft were operation time, postoperative bleeding, need for catecholamines, requirement of intensive care, perioperative myocardial infarction and mortality. The number of distal anastomoses in each group was 3.1 (2-5). The operation time varied in compliance with the number of distal anastomoses, but there were no significant differences between both groups. Postoperative bleeding until the second postoperative day was 905 ml in group II versus 569 ml in group I; the difference was significant (p < 0.05). The need of catecholamines after operation and hemodynamic parameters were comparable in both groups, there were no significant differences. Intensive care was required for a mean of 1.6 days in both groups, postoperative ventilation was 5.8 hours in group I versus 7.9 hours in group II, differences not significant. Ischemia or myocardial infarction could be demonstrated in 2 patients of group I (3%) versus 4 patients of group II (5.7%). The differences between the groups were not significant. Cardiac low output syndromes without sights of myocardial infarction were apparent in 9 patients of group I (13.5%) versus 2 patients of group II (2.9%), this difference being significant (p < 0.05). Mortality after operation in both groups was higher than in patients with normal ventricular function, however the differences between the evaluated groups were not significant (5.9% in group I versus 4.3% in group II). Summarizing the above it can be concluded that patients with poor left ventricular function are at a higher risk when subjected to bypass operation; the use of IMA did not show any disadvantages in comparison to exclusively veingraft surgery, except of a higher perioperative bleeding risk. Due to better long term results IMA should be used routinely also in bypass-patients with poor left ventricular function.

Aged↗

PubMed1993

[Transesophageal echocardiography for evaluating left ventricular function].

By means of transesophageal echocardiography it is now possible to assess and to monitor left ventricular function during anesthesia and surgery. Furthermore, the determinants of the left ventricular function (preload, afterload and contractility) can also be evaluated in real time. Based on this information, a specific therapy can be started immediately should ventricular function become inadequate. In addition to global function, regional ventricular function can be analyzed at the same time. The detection of regional wall motion abnormalities can be most helpful for anesthetic management of patients with coronary heart disease and for the diagnosis of intraoperative myocardial ischemia.

Anesthesia Recovery Period↗

PubMed2000

Study of the value of corrected ejection fraction in the evaluation of left ventricular function in patients with mitral or aortic regurgitation.

Evaluation of left ventricular function in the presence of valvular regurgitation is still a clinical problem because ejection phase indices including ejection fraction are heavily dependent on preload and afterload and cannot be regarded as reliable indices of contractility in diseases associated with altered loading conditions. The authors attempted to evaluate the usefulness of the new index-corrected ejection fraction in the evaluation of left ventricular (LV) function in patients with chronic mitral (MR) or aortic regurgitation (AR). The study included 21 patients with chronic severe MR (11 patients) and AR (10 patients) with a mean age of 18 years. All patients underwent valve replacement or repair. Echo Doppler study was performed preoperatively and postoperatively and included measurement of the following LV parameters: end-diastolic dimension (EDD), end-diastolic volume (EDV), end-systolic dimension (ESD), end-systolic volume (ESV), ejection fraction (EF), systolic blood pressure/end-systolic dimension (SBP/ESD); also mitral and aortic stroke volume were calculated cross-sectional area (CSA) x time velocity integral TVI. Corrected ejection fraction (EFc) was derived from the following equation: EFc = [EF + square root of (ASV x MSV) / EDV] / 2. The mean preoperative EFc did not change significantly after surgical correction of mitral or aortic regurgitation. Preoperative EFc did not show significant difference compared with postoperative EF in the two groups. Preoperative EFc correlated significantly with other preoperative and postoperative indices of LV function. Postoperative EFc showed very close correlation with other postoperative parameters. Thus, using the new index-corrected ejection fraction in the assessment of LV function in patients with mitral or aortic regurgitation has several advantages: Noninvasive, independent of loading changes, helpful in predicting the immediate postoperative clinical course, and a reliable index for evaluation of LV systolic function preoperatively and postoperatively.

Adolescent↗

PubMed2003

The nitric oxide donor S-nitroso-N-acetylpenicillamine (SNAP) increases free radical generation and degrades left ventricular function after myocardial ischemia-reperfusion.

BACKGROUND: During reperfusion of ischemic myocardium nitric oxide (NO) reacts with superoxide radicals to form cardiotoxic peroxynitrite, which causes lipid peroxidation. Our hypothesis was that infusion of a NO donor S-nitroso-N-acetylpenicillamine (SNAP) during ischemia-reperfusion would exacerbate the oxidative damage to the myocardium by increased formation of nitrogen radicals. METHODS AND RESULTS: In 19 open-chest dogs, left anterior descending (LAD) coronary occlusion (15 min)-reperfusion (15 min) sequences were created. Using electron paramagnetic resonance (EPR), we monitored the coronary sinus concentration of ascorbate free radical (Ascz*-), a measure of free radical generation (total oxidative flux). Seven control dogs (Group 1) received intravenous saline infusion during occlusion-reperfusion, while 12 dogs received SNAP infusion (Group 2: 2.5 microg/min per kg SNAP, and Group 3: 5 microg/min per kg SNAP). Left ventricular fractional area shortening was determined by echocardiography. Dogs in Group 3 receiving a high dose of SNAP (5 microg/min per kg) demonstrated a higher Ascz*- concentration increase than the control group. Percent fractional area shortening in Group 1 declined from 77+/-4.0 (baseline) to 54+/-9.0% during ischemia (P<0.05), and then fully recovered to 74+/-3.7% with reperfusion. In the SNAP-treated dogs, the percent fractional area shortening during reperfusion was significantly lower than baseline in Group 2 (55+/-3.9 vs. baseline 74+/-4.4%, P<0.05) and in Group 3 (49+/-5.0 vs. baseline 71+/-4.5%, P<0.01). In five additional dogs, nitrotyrosine immunohistochemistry showed heavy staining of the ischemic-reperfused myocardium. CONCLUSIONS: The NO donor SNAP increased free radical concentration and exacerbated myocardial oxidative damage after ischemia-reperfusion.

Animals↗

PubMed2006

Ultrasonographic study of left ventricular function at rest in a group of highly trained black African handball players.

AIMS: Most of the studies of athlete's heart have been performed on Caucasian and yet, evidence suggests that there are racial differences in the response of the heart to certain pathological conditions such as hypertension. This study aimed to evaluate the morphologic cardiac changes in a group of highly trained Cameroonian handball players. METHODS AND RESULTS: We studied cardiac morphology and function as assessed by echocardiography at rest in 21 asymptomatic international level handball players and 21 age-, sex-, height- and weight-matched sedentary controls. Echocardiographic variables were compared between groups using unpaired t-test. Compared with controls, wall thickness, relative wall thickness (h/R), left ventricular (LV) mass, LV end diastolic diameter (LVEDD) and left atrial diameter were significantly greater in athletes. None of the athlete exhibited a wall thickness above 12 mm. The ejection fraction (EF) and the mitral pattern on pulsed wave Doppler did not differ in the two groups. CONCLUSIONS: Both LVEDD and wall thickness of elite Cameroonian handball players are increased. There is an increased h/R. The LV EF was normal and not supranormal, as is sometimes believed. These cardiac changes are consistent with cardiac adaptation required in this type of sportsmen who are submitted both in endurance and resistance training.

Adult↗

PubMed1987

Operative management of coronary artery disease with poor left ventricular function.

In order to evaluate CABG in patients with depressed left ventricular function, 117 patients with an EF under 35 percent were analyzed. All patients had angina pectoris. Congestive heart failure was present in 38 percent, and one or more myocardial infarctions in 90 percent. The period of followup was up to 72 months. The hospital mortality rate was 4 percent and the late mortality rate 6 percent. Although ideal randomized trials comparing surgical and medical therapy in patients with angina and depressed left ventricular function are not available, we nevertheless believe that CABG should be available to this subset of patients. The majority of these patients will derive clinical benefit from CABG.

Adult↗

PubMed2004

The acute administration of trimetazidine modified myocardial perfusion and left ventricular function in 31 patients with ischaemic ventricular dysfunction.

UNLABELLED: Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamibi uptake in myocardial single photon emission tomography (SPECT). The aim of this study was to evaluate whether the acute administration of TMZ improved myocardial perfusion and modified left ventricular ejection fraction (LVEF) in ischaemic left ventricular impairment. METHODS: Thirty-one patients (23 males, age 66 years) with prior myocardial infarction (>6 months) and echocardiographic LVEF < or = 45% underwent coronary angiography, rest basal myocardial SPECT (after 3-day placebo administration) and rest TMZ myocardial SPECT [after 3-day TMZ administration (60mg/die)]. The left ventricle was analysed in 16 segments. The summed placebo score (SPS) and the summed TMZ score (STS) were calculated with a 5-point scale (from 0 = normal uptake to 4 = absent uptake) by two blinded operators. The GATED Tc-99m SPECT was always provided. RESULTS: After TMZ administration GATED LVEF improved from 26.5+/-9.7% to 29.1+/-11.3% (p = 0.04) and left ventricular end-systolic volume (LVESV) was reduced from 90.2+/-40.7 to 85.6+/-39.2 ml/mq (p = 0.006). Similarly the addition of TMZ to myocardial SPECT significantly reduced the STS compared to SPS (21.5+/-11 vs. 26.6+/-10.5 p = 0.0001). Eleven patients (35.5%) had an echocardiographic LVEF < or = 30%; in these patients who had severe ventricular dysfunction, GATED LVEF and LVESV did not change after TMZ (20.2+/-5.7% vs. 21+/-6.9% p =0.6; 116.7+/-35.3 ml vs. 112.6+/-32.3 ml p = 0.08, respectively). CONCLUSION: In comparison with placebo, the addition of TMZ to myocardial Tc-99m tetrofosmin SPECT improved myocardial perfusion and LVEF, reducing LVESV. These effects were lost in patients with more severe ventricular dysfunction.

Adult↗

PubMed1992

Decreased concentration of myofibrils and myofiber hypertrophy are structural determinants of impaired left ventricular function in patients with chronic heart diseases: a multiple logistic regression analysis.

OBJECTIVES: The aim of this study was to perform a multiple logistic regression analysis to identify independent structural determinants of impaired left ventricular function. BACKGROUND: The association between contractile failure and structural alterations of the myocardium has been demonstrated in several studies, and multiple interactions between myocardial structure and cardiac performance are likely. METHODS: Morphometric data assessed from 130 left ventricular biopsy specimens were analyzed. The endomyocardial specimens were obtained from 57 patients with normal coronary arteries (17 with normal left ventricular ejection fraction and 40 with impaired left ventricular function [dilated cardiomyopathy]), 15 patients with hypertrophic cardiomyopathy and 32 patients with aortic valve disease. Transmural biopsy specimens were assessed in 6 donor hearts before heart transplantation and in 20 patients with left anterior descending coronary artery disease whose specimens were obtained from the left ventricular anterior wall during aortocoronary bypass surgery. Global or regional left ventricular function was evaluated from left cineventriculograms. The volume fraction of cardiac fibrous tissue, intracellular volume fraction of myofibrils, volume fraction of myofibrils related to myocardial tissue (including fibrosis) and myofiber diameters were determined from semithin sections of the biopsy specimens with the use of light microscopic morphometry. RESULTS: Multiple logistic regression analysis revealed decreased volume fraction of myofibrils (p < 0.005) and increased fiber diameter (p < 0.002) as independent determinants of impaired left ventricular function. CONCLUSIONS: These data indicate that, independent of the underlying heart disease, both decreased concentration of contractile proteins and myocyte hypertrophy are independently associated with impaired left ventricular function.

Age Factors↗

PubMed1994

Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function.

BACKGROUND: Vasodilator therapy with nifedipine reduces left ventricular volume and mass and increases the ejection fraction in asymptomatic patients with severe aortic regurgitation. METHODS: To assess whether vasodilator therapy reduces or delays the need for valve replacement, we randomly assigned 143 asymptomatic patients with isolated, severe aortic regurgitation and normal left ventricular systolic function to receive either nifedipine (20 mg twice daily, 69 patients) or digoxin (0.25 mg daily, 74 patients). RESULTS: By actuarial analysis, we determined that after six years a mean (+/- SD) of 34 +/- 6 percent of the patients in the digoxin group had undergone valve replacement, as compared with only 15 +/- 3 percent of those in the nifedipine group (P < 0.001). In the digoxin group, valve replacement (in a total of 20 patients) was performed because of left ventricular dysfunction (ejection fraction < 50 percent) in 75 percent, left ventricular dysfunction plus symptoms in 10 percent, and symptoms alone in 15 percent. In the nifedipine group, all six patients who underwent valve replacement did so because of the development of left ventricular dysfunction. In addition, all the patients in both groups who underwent aortic-valve replacement had an increase of 15 percent or more in the left ventricular end-diastolic volume index. After aortic-valve replacement, 12 of the 16 patients (75 percent) in the digoxin group and all six patients in the nifedipine group who had had an abnormal left ventricular ejection fraction before surgery had a normal ejection fraction. CONCLUSIONS: Long-term vasodilator therapy with nifedipine reduces or delays the need for aortic-valve replacement in asymptomatic patients with severe aortic regurgitation and normal left ventricular systolic function.

Adult↗

PubMed1984

[Left ventricular function at rest and during exercise in patients with arterial hypertension. Studies using digital subtraction angiocardiography].

Using digital subtraction angiography, left ventricular function and pulmonary artery pressure at rest and during submaximal exercise (98 +/- 33 watts) were examined in 25 patients with systemic hypertension. All patients had normal coronary arteries and a normal left ventricular function at rest. Heart rate increased in all patients (from 82 +/- 14 to 134 +/- 20 min-1, p less than 0.001). Systolic blood pressure also increased significantly in all patients (from 153 +/- 12 to 190 +/- 14 mmHg, p less than 0.001). End-diastolic and end-systolic volumes did not change on average (89 +/- 22 and 87 +/- 19 ml/m2, 28 +/- 8 and 28 +/- 10 ml/m2, respectively), neither did stroke volume nor ejection fraction (61 +/- 18 and 59 +/- 16 ml/m2, 68 +/- 7 and 67 +/- 9%, respectively). The increase in end-systolic volumes and concomitantly the decrease in ejection fraction during exercise in 8 patients points to an impairment of left ventricular function. This effect is frequently found in ventricles with less distinct hypertrophy. Cardiac index increased in each patient (from 5.1 +/- 2.1 to 8.2 +/- 2.9 I/min/m2, p less than 0.001). This is caused by the increase in heart rate while stroke volume remains unchanged. Mean pulmonary artery pressure increased in all patients from 19 +/- 6 to 35 +/- 10 mmHg on average (p less than 0.001). A pathologic increase could be observed in 18 patients. There was no correlation to angiographic parameters of left ventricular function. The exercise test was stopped in 12 patients mainly because of dyspnea. In 11 of these patients a pathologic increase of mean pulmonary artery pressure was found. As in these patients the angiographic parameters of left ventricular function were normal, the increase in pulmonary pressure is related to an impairment of diastolic function caused by hypertrophy.

Adult↗

PubMed1993

Two-dimensional echocardiographic assessment of regional left ventricular function and geometry following myocardial reperfusion.

Two-dimensional echocardiography is ideally suited for the serial noninvasive assessment of regional function and geometry following reperfusion therapy. Patients with substantial myocardial salvage show slow but definite recovery in regional function within the first 2 weeks. The extent of recovery seems to be associated with the degree of necrosis. Patients with some salvage, which is not enough to cause recovery in regional function, may demonstrate lack of infarct expansion and left ventricular (LV) dilatation. In the future, newer approaches such as pharmacologic challenge may play a role in defining post-ischemic myocardium early after the ischemic event.

Echocardiography↗

PubMed2006

The impact of hypertension on systolic and diastolic left ventricular function. A tissue Doppler echocardiographic study.

BACKGROUND: The purpose of this study is to assess the impact of hypertension on systolic function and diastolic function using 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and tissue Doppler imaging (TDI) of the mitral annulus. METHODS: From an outpatient clinic population, 414 consecutive patients underwent 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and TDI of the septal, lateral, inferior, and posterior walls near the mitral annulus. Parameters of systolic left ventricular (LV) function and diastolic LV function were assessed. Patients were divided according to the presence or absence of systemic hypertension (blood pressure > or = 140/90 mm Hg on > or = 3 measurements or treatment with antihypertensive medication). RESULTS: A complete echocardiographic evaluation was obtained in 397 patients. Among these, 269 (68%) had hypertension. There was no difference with respect to age between patients with and without hypertension. Patients with hypertension had higher LV mass index and relative wall thickness and lower TDI peak systolic velocity (V(S)) when compared with patients without hypertension. In addition, indices of diastolic LV function were significantly impaired in hypertensive patients. CONCLUSIONS: Quantitative echocardiography using TDI reveals that hypertensive patients with preserved global LV systolic function often have combined impairment of systolic function and diastolic function.

Coronary Circulation↗