Changes in left ventricular filling dynamics with treadmill exercise in normal and hypertensive subjects

Journal of Clinical and Basic Cardiology 1999; 2 (1): 89-91

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Keywords: Belastung,  diastolische Dysfunktion,  Hypertonie,  diastolic dysfunction,  exercise,  hypertension

In patients with resting left ventricular diastolic abnormalities, it is not known if their transmitral diastolic flow velocity patterns in response to exercise are different from the response seen in normal subjects. Treadmill stress echocardiography was performed on 31 normotensives (Group 1), 16 hypertensives without LVH (Group 2), and 14 hypertensives with mild LVH on resting echo (Group 3). All tests were negative for ischaemia, and all subjects reached greater than 85 % of predicted maximum heart rate for age. Transmitral flow was measured by pulsed Doppler with the sample volume at the mitral anulus in the 4 chamber view at rest, immediately post-exercise at peak heart rate, and 12 minutes post exercise. Lower E/A mean ratios were found at rest in Group 2 (0.88) and Group 3 (0.87) compared to Group 1 (0.95) indicating a resting diastolic abnormality in the hypertensive groups (p < 0.05). With exercise, all 3 groups showed similar significant (p < 0.05) increases in both the mean E velocity (+15.7 %, +11.2 %, +l6.5 %) and the mean A velocity (+18.8 %, +11.2 %, +l6.9 %) compared to rest values. All 3 groups showed no significant change in the E/A ratio or the deceleration time with exercise. At 12 minutes, the mean E and mean A velocities had returned to mean resting values in all 3 groups. The response of left ventricular filling dynamics to treadmill exercise in hypertensives is similar to that seen in normal subjects even in the presence of resting diastolic abnormalities and when mild LVH is present. J Clin Basic Cardiol 1999; 2: 89-91.