Regional left ventricular distribution of abnormal segmental relaxation evaluated by strain echocardiography and the incremental value over annular diastolic velocities in hypertensive patients with normal global diastolic function

Improved left ventricular diastolic function with exercise training in hypertension: a Doppler imaging study

Objective. To study the effects of 6 months' exercise training on ventricular function in hypertensive patients. Methods. Both groups received routine anti-hypertensive pharmacological therapy and one received a 6 months' exercise program in addition. All patients underwent incremental cardiopulmonary exercise test and echocardiography in baseline and after 6 months. Results. (1) In 6 months' follow-up, Peak_VO2, Power_max (max workload), AT (anaerobic threshold), VO_2AT (VO₂ at anaerobic threshold), t_AT (time from beginning to anaerobic threshold) (P < .05), were increased in the exercise group. HR_rest (Heart rate at rest) was decreased (P < .05). LAVI (left atrial volume index), peak mitral filling velocities during early (E) and late (A) diastole E/A ratio, DT(deceleration time of the mitral E wave), IVST(Interventricular septum thickness in diastole), tissue Doppler indice Mean Ea/Aa ratio (P < .05) were also improved. (2) Correlation analysis: 4 variates had significant effect on change of Peak_VO2 in the exercise group: age (r = −0.39), change of HR_rest (r = 0.59), change of E/A (r = 0.55), change of Mean Ea/Aa (r = 0.58); Through analyzing 2 groups patients' baseline values, their age (β = − 0.32), VO_2AT (β = 0.29), HR_rest (β = − 0.25), LAVI (β = − 0.24), E/A (β = 0.41) were found to be independent predictors of MeanEa/Aa. P-value under .05 was considered statistically significant. Conclusion. 6 months' exercise could enhance hypertensive patients' aerobic exercise level and diastolic function to a certain extent.

Echocardiographic Evaluation of Diastolic Function

Left ventricular diastolic dysfunction is common in patients with heart failure. Echocardiographic evaluation of diastolic function provides the clinician with important information about ventricular relaxation and estimation of filling pressures. Optimal evaluation includes the integration of multiple echocardiographic parameters such as Doppler, M-mode, and volumes. This article aims to review the components of diastolic filling and ventricular performance, as well as discuss the techniques used for the assessment of left ventricular diastolic function.