| Effect of the Valsalva manoeuver on diastolic filling indices in patients with essential hypertension. | |
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MedLine Citation:
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PMID: 11550106 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In some hypertensive patients, echocardiographic examination does not reveal any pathologic finding in spite of a documented blood pressure elevation. In our study, we investigated the effect of preload reduction with Valsalva manoeuver on transmitral flow velocities in hypertensive patients with normal mitral flow pattern and compared the results with a healthy control group. Sixty-eight patients without evidence of coronary artery disease or heart failure (28 female, 40 male, age 50 +/- 7) were divided in two groups according to their E/A ratio as those with diastolic dysfunction (n = 36) and without diastolic dysfunction (DD(-): n = 32). DD(-) patients and the control group (n = 20) performed Valsalva manoeuver and their pulsed-Doppler mitral flow measurements were repeated at the strain phase. During Valsalva manoeuver, E wave velocity decreased in all subjects. In the controls, peak A velocity showed a similar decline and E/A ratio remained over 1.0. However, in 72% of DD(-) patients A velocity did not change or increased and their E/A ratio fell below 1.0. In 47% of the patients with an E/A ratio reversal after Valsalva manoeuver, myocardial perfusion scintigraphy revealed reversible defects whereas none of the patients whose E/A ratio remained over 1.0 had perfusion defects. It is concluded that: (1) in hypertensive patients with normal E/A ratio Valsalva manoeuver should be performed in order to unmask a probable false normal finding, (2) an important percent of hypertensive individuals have left ventricular relaxation abnormalities, and (3) diastolic dysfunction develops together with a decrease in coronary reserve. |
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Authors:
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D Ural; E Ural; G Kahraman; O Caymaz; C Aktolun; B Komsuolu |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of human hypertension Volume: 15 ISSN: 0950-9240 ISO Abbreviation: J Hum Hypertens Publication Date: 2001 Sep |
Date Detail:
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Created Date: 2001-09-10 Completed Date: 2001-10-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 607-12 Citation Subset: IM |
Affiliation:
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Kocaeli University, Medical Faculty, Department of Cardiology, Kocaeli, Turkey. dilek_ural@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Flow Velocity / physiology Coronary Circulation / physiology Diastole / physiology* Echocardiography, Doppler, Pulsed Female Heart Rate / physiology Humans Hypertension / physiopathology*, ultrasonography Male Middle Aged Mitral Valve / physiopathology, ultrasonography Valsalva Maneuver / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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