Doppler echocardiographic evaluation of diastolic function in hypertensive cardiomyopathies.

In hypertensive cardiomyopathies, diastolic function is abnormal due to impaired relaxation associated with left ventricular hypertrophy, and a variable degree of reduction in left ventricular compliance may also be present. Abnormal relaxation can be indicated from prolonged isovolumic relaxation time and reduced early diastolic mitral inflow velocity, as well as from a reduced rate of posterior wall thinning and the neg dp/dt estimated from a continuous wave recording of mitral regurgitation. Reduction in left ventricular compliance can be assessed from shortening of the mitral A-wave, and from increased flow reversal in the pulmonary veins at atrial contraction. Non-invasive assessment of LV diastolic function is therefore possible by recording mitral and pulmonary venous flow velocities and posterior LV wall motion.