How Should We Assess Diastolic Function in Hypertension?

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Abstract
Objective: the aim of our study was to assess the relative merits of three indices of diastolic LV function in a group of patients with hypertension and normal systolic function and a group of healthy controls. Design: In this echocardiographic study, diastolic LV function was assessed by E/A ratio using pulsed Doppler recording and by atrial to total mitral annulus motion (AC) and maximal longitudinal LV relaxation velocity (RVm) by M-mode recordings from apical views. The study took place in the Department of Clinical Physiology in a secondary referral centre. Nineteen consecutive patients with uncomplicated hypertension referred to echocardiographic examination and 20 age- and sex-matched controls were included in the study. Results: All three measures of diastolic function, E/A ratio, AC and RVm indicated impaired diastolic function in the hypertensive group, compared to the healthy controls. However, E/A ratio and AC showed a considerable overlap between the groups, whereas there was a highly significant difference in RVm between the hypertensive group and the controls, with much less of an overlap. Conclusion: The results indicate that of these three indices of diastolic function, RVm may be the most appropriate in patients with hypertension and normal systolic LV function.