Is pulsed Doppler echocardiography an adequate method to evaluate left ventricular function during filling in hypertensive patients?

Abstract

Pulsed Doppler tracings of the mitral inflow are often proposed to describe left ventricular function during filling in hypertensive patients. The tracings are determined by the complex interaction of left atrial pressure and left ventricular relaxation, diastolic compliance and contractility of the left atrium. They strongly depend on preload and, thus, do not allow precise characterization of the left ventricle. In addition, they vary with age, heart rate and the site of measurement. The modifications caused by the presence of hypertensive hypertrophy are not specific: similar changes are seen for example, in the presence of hypertrophic cardiomyopathy or coronary heart disease, but are absent in highly trained athletes in spite of very significant physiologic hypertrophy.