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Assessment of the left ventricular diastolic reserve in essential hypertension: the acute saline load test
dc.creator | Triposkiadis, F. | en |
dc.creator | Moyssakis, I. | en |
dc.creator | Makris, T. | en |
dc.creator | Hatzizaharias, A. | en |
dc.creator | Hadjinikolaou, L. | en |
dc.creator | Kyriakidis, M. | en |
dc.date.accessioned | 2015-11-23T10:50:27Z | |
dc.date.available | 2015-11-23T10:50:27Z | |
dc.date.issued | 2001 | |
dc.identifier | 10.1046/j.1365-2362.2001.00873.x | |
dc.identifier.issn | 0014-2972 | |
dc.identifier.uri | http://hdl.handle.net/11615/33730 | |
dc.description.abstract | Objectives The aim of this study was to evaluate the significance of the development of a restrictive response to an acute saline load, defined as an increase in the ratio of peak early to peak late diastolic transmittal flow velocity (E/A ratio) associated with a decrease in the deceleration time, in patients with mild to moderate untreated hypertension. Background Recognised abnormal patterns of transmittal diastolic flow include, from 'best' to 'worst': prolonged relaxation, pseudonormalisation, and restrictive physiology. The common denominator of these transitions is the constellation of an increase in the E/A ratio associated with a decrease in deceleration time. Patients and Methods Sixteen normal control subjects (6 males, 10 females, age 51.6 +/- 6.9 years) and 24 patients with mild to moderate untreated hypertension (12 males, 12 females, age 46.8 +/- 7.5 years) underwent supine blood pressure measurement with sphygmomanometry, biochemical studies, and transthoracic M-mode, 2D, and Doppler echocardiography before and after an acute saline load (7 mL kg(-1), maximum 500 mL, NaCl 0.9% within 15 min IV). Results The baseline E/A ratio was lower (0.90 +/- 0.14 vs. 1.04 +/- 0.18; P < 0.01) and the deceleration time was longer (158.8 +/- 19.4 vs. 135 +/- 8.9 ms; P < 0.01) in patients with hypertension compared with normotensive controls. However, no patient with hypertension exhibited a transmittal flow velocity pattern compatible with typical prolonged relaxation. A restrictive response to the acute saline load was observed in 12 (50%) of the hypertensive and none of the control subjects. Hypertensive patients with a restrictive response to the acute saline load had a lower baseline E velocity (54.8 +/- 8.7 cm s(-1) vs. 66 +/- 6.4 cm s(-1); P = 0.003), a lower baseline E/A ratio (0.83 +/- 0.13 vs. 0.97 +/- 0.12; P = 0.015), and a longer deceleration time (167.5 +/- 15.4 ms vs. 150 +/- 19.5; P = 0.03) than hypertensive patients without such a response. Conclusion A restrictive response to an acute saline load is indicative of a limited diastolic reserve in patients with mild to moderate untreated hypertension. Further studies are required in order to evaluate the significance of such a response with regards to risk stratification and efficacy of medical treatment in this patient population. | en |
dc.source.uri | <Go to ISI>://WOS:000170667200006 | |
dc.subject | diastolic reserve | en |
dc.subject | hypertension | en |
dc.subject | saline load | en |
dc.subject | CONGESTIVE-HEART-FAILURE | en |
dc.subject | FLOW VELOCITY PATTERNS | en |
dc.subject | DOPPLER-ECHOCARDIOGRAPHY | en |
dc.subject | SYSTEMIC HYPERTENSION | en |
dc.subject | MITRAL FLOW | en |
dc.subject | MASS | en |
dc.subject | DYSFUNCTION | en |
dc.subject | AMYLOIDOSIS | en |
dc.subject | INSIGHTS | en |
dc.subject | FEATURES | en |
dc.subject | Medicine, General & Internal | en |
dc.subject | Medicine, Research & Experimental | en |
dc.title | Assessment of the left ventricular diastolic reserve in essential hypertension: the acute saline load test | en |
dc.type | journalArticle | en |
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