Background: The prevalence of left ventricular(LV) diastolic dyssynchrony was reported to be high in diastolic heart failure. Although hypertensive(HT) patients are prone to diastolic heart failure, LV diastolic dyssynchrony and its determinants were rarely investigated. We evaluated whether increased LV mass may be a causative factor for LV diastolic dyssynchrony in HT patients.
Methods: We consecutively enrolled 55 normal controls and 109 HT patients. Comprehensive echocardiographic examination was performed after at least 24 hours of discontinuation of anti-hypertensive medications. For the assessment of LV dyssynchrony, various LV systolic and diastolic synchronicity indexes were measured using tissue Doppler image.
Results: Diastolic dyssynchrony indexes were significantly higher in HT patients than normal controls. LV mass index(p=0.005, r=0.27), age(p=0.04, r=0.20), and the ratio of early to late mitral inflow velocity(p=0.01, r=-0.24) were significantly correlated with LV diastolic synchronicity indexes(fig.), whereas QRS duration, blood pressure, and LV systolic synchronicity indexes were not. On multivariate linear regression analysis, LV mass index(p<0.001) and age(p=0.03) emerged as the determinants of LV diastolic synchronicity indexes.
Conclusion: Increased LV mass induced by chronic LV pressure-overload contributes to developing LV diastolic dyssynchrony. Given the clinical importance of LV hypertrophy, we suggest that LV diastolic dyssynchrony has a possible role in producing diastolic heart failure in HT patients.