Regional wall motion abnormalities during early diastole in patients with hypertensive left ventricular hypertrophy: a Doppler tissue echocardiographic study

To investigate left ventricular wall motion asynchrony in patients with hypertensive heart disease, we measured regional myocardial velocity in hypertensive patients with left ventricular hypertrophy and in normotensive individuals using tissue Doppler imaging. The endocardial velocity and the myocardial velocity gradient were measured in the basal and mid segments of the septal and posterior walls. The dilating velocity of the left ventricular cavity were determined for the basal and mid ventricular segments of left ventricle. The peak myocardial velocity gradient was significantly lower in the hypertensive group than in the control group for all regions. The peak endocardial velocity during early diastole in the mid ventricular septum was significantly lower in the hypertensive group (Hypertensive vs Controls; 3.8 +/- 1.3 vs 5.1 +/1.6 cm/s, P < 0.05), whereas the peak endocardial velocity at the other three sites were similar in the two groups. The peak dilating velocity was significantly lower in the hypertensive group only in the mid portion of the left ventricle (Hypertensive vs Controls; 7.2 +/- 2.4 vs 9.8 +/- 1.3 s(-1), P < 0.005). These results suggest that there were regional wall motion abnormalities and nonuniformity during the early diastolic phase in the hypertensive hearts with left ventricular hypertrophy.