Combined Doppler and M-mode analysis of diastolic filling behaviour in arterial hypertension with and without left ventricular hypertrophy.

The authors analysed Doppler and M-mode derived diastolic parameters of left ventricular filling in patients with arterial hypertension with and without left ventricular hypertrophy (LVH) and with hypertrophic nonobstructive cardiomyopathy (HNCM). In hypertrophied hearts they demonstrated that the transmitral flow during rapid filling phase was significantly reduced. The lower early diastolic flow is compensated by an augmentation of atrial systole. Diastolic filling anomalies are the consequence of an impaired ventricular relaxation due to LVH as could been proved by the M-mode derived retraction constant Te. Diastolic filling anomalies significantly depend on the extent of left ventricular hypertrophy. Impaired diastolic function was found in hypertensive patients without LVH. In this case, diastolic disorders indicate an early involvement of the heart in the hypertensive process.