Diastolic function in hypertension

Abstract

Diastolic dysfunction in patients with hypertension may present as asymptomatic findings on noninvasive testing, or as fulminant pulmonary edema, despite normal left ventricular systolic function. Up to 40% of hypertensive patients presenting with clinical signs of congestive heart failure have normal systolic left ventricular function. In this article we review the pathophysiologic factors affecting diastolic function in individuals with diastolic function, current and emerging tools for measuring diastolic function, and current concepts regarding the treatment of patients with diastolic congestive heart failure.

Clinical value of myocardial performance index in patients with isolated diastolic dysfunction

“…After multiple regression analysis, only the LV mass was considered independent predictor of TDI-MPI, which is in accord with a previous study [14]. The correlation between mass and TDI-MPI may be related to the large number of patients with LV hypertrophy, which results in high collagen deposition, decreased LV relaxation and distensibility with a negative impact on ventricular performance [25].…”

Doppler‐Derived Myocardial Performance Index in Patients with Impaired Left Ventricular Relaxation and Preserved Systolic Function

“…Concentric LV hypertrophy implies an increased RWT and is characterized by interstitial collagen deposition. This results in increased chamber stiffness with a negative impact on the LV performance 39,40 . The negative relationship between E‐wave and MPI has also been demonstrated by others 41,42 and seems to represent a potential dependency of the MPI with compliance and left atrium pressure 30 …”

Hypertensive heart failure: A review of clinical status and meta-analyses of prognostic value of echocardiography and antihypertensive medication

“…The present findings suggest that diastolic and systolic dysfunction are important mechanisms in the progression of LVH to HHF. Diastolic dysfunction: Diastolic dysfunction is a major factor in the pathophysiology of HHD and its progression to symptomatic HHF [72]. About 40% of HHD patients have a normal systolic function (LVEF) but with an abnormal diastolic function [72,73].…”

“…Diastolic dysfunction: Diastolic dysfunction is a major factor in the pathophysiology of HHD and its progression to symptomatic HHF [72]. About 40% of HHD patients have a normal systolic function (LVEF) but with an abnormal diastolic function [72,73]. Diastolic dysfunction is the main cause of the development of symptomatic HF in hypertensive patients [74].…”

“…LV diastolic dysfunction manifests as increased LV wall thickness and chronically elevated LV end-diastolic pressure leading to increased LA volume [5]. The increase in LV volume is the consequence of elevated LV filling pressure or LA pressure manifesting as exercise intolerance in HHF patients [72]. Myocardial ischemia is another key factor in the mechanism of leading to diastolic impairment in HHF while hypertension accelerates arteriosclerosis in both systemic and coronary arteries [75].…”