Pulsed-wave Tissue Doppler Imaging on the evaluation the effect of Valsartan on the left ventricular diastolic function

Objective:To assess the effect of Valsartan on the left ventricular diastolic function by newly Pulsed-wave Tissue Doppler Imaging (PW-TDI). Methods: Totally 34 cases of primary hypertension (EH) were divided into two groups (H 0, H 1) according to the course of disease. 12 patients in H 0 group were in stage I; 22 in group H 1 were in stageⅡand Ⅲ. The left ventricular (LV) geometry and diastolic function were examined by PW-TDI and conventional M-mode echo, PW-CDFI. The sample line were separately placed at the mitral vavle annular (MVA) in the lateral wall of LV (LVLW), ventricular septal of LV (LVS), anterior wall and inferior wall of LV (LVAW, LVIW) in apical four-chamber view and two-chamber view in PW-TDI. The peak velocity of MVA in early diastolic phase (E m) and the peak velocity in late diastolic phase (A m) were recorded. Results: ①Though LV mass (LVM) and the LV mass index (LVMI) were slightly increased by compared with normal standard in H o group, LV diastolic dysfunction had occurred. E m decreased, A m increased, E m/A m1 in PW-TDI.Tthe same result could be observed in PW-CDFI. ② Besides LVM, LVMI significant increase in group H 1( P0.05 )by compared with group H 0), E m further decreased by compared with that in group H 0 (P0.05), E m/A m1. However the decrease of ration of e to a (E/A ) was not significant in PW-CDFI. ③ Given Valsartan 14 weeks in all subjects, the diastolic function in two groups improved. The ration of E m to A m was normal in group H 0; The E m/A m had significant increased by compared with that in base situation (0.96 vs 0.68,P0.05) in group H 0. The LV hypertension was blocked in some degree. Conclusion: Pulsed-wave Tissue Doppler imaging could reflect mechanistic characters of myocardial fibril. It could be early used to detect the diastolic dysfunction in patients of essential hypertension and show the improvement of diastolic function through the treatment of Valsartan.