Left ventricular diastolic dysfunction in primary hypertension and ischemic heart disease-evaluation by doppler echocardiography

Rahul Kumar, Sanjeev Diwakar, Srinivas .


Background: Congestive heart failure caused by a predominant abnormality in diastolic function is both common and causes significant morbidity and mortality. The objective of the study was to evaluate application of doppler echocardiography in determining left ventricular diastolic dysfunction in ischemic heart disease and essential hypertension.

Methods: Present study is based on analysis of 75 patients of hypertension and 60 patients of IHD (UA, AMI, IMI) admitted to Bapuji and Chigateri general hospital during December 2019 to November 2020. Detailed history and physical examination were done. Every patient was subjected to ECG, CXR, routine investigations and Doppler Echo cardiography.

Results: A total of 75 patients of primary hypertension were studied. 37 patients showed diastolic dysfunction with E/A ratio <1, with increased atrial filling fraction. Out of 37 patients, 24 showed LVH and 13 cases did not have LVH. A total of 60 patients of ischemic heart disease were studied. 23 patients showed diastolic dysfunction with E/A ratio <1, with increased atrial filling fraction and prolonged isovolumetric relaxation time.

Conclusions: Our findings suggest that myocardial damage in patients with HTN and IHD affects diastolic dysfunction before systolic dysfunction. Doppler echocardiography is a valuable non-invasive method to detect left ventricular diastolic impairment and the intentional assessment of diastolic function is advisable for early detection of LV dysfunction before clinical symptoms appear.


Doppler echocardiography, Primary hypertension, Ischemic heart disease, Diastolic dysfunction

Full Text:



Guyton AC, Hall JE. Chapter 9. Textbook of medical physiology 11th Edition. Elsevier Saunders 2006;106-8.

Chaturvedi V, Bhargava B. Health Care Delivery for Coronary Heart Disease in India –Where Are We Headed. Am Heart Hosp J. 2007;5:32-7.

Mohan JC. Prevalence, Awareness, Treatment, control and Risk factors of hypertension in India and its Neighborhood Newer Data and older perspective. Indian Heart J. 2006;58:7-9.

Gulati RB, Singh J, Makhle CN. J Asso Phy Ind. 1992;40(9):577-78.

Zile MR, Brutsaert DL. New concepts in DD and diastolic heart failure: Part I. Diagnosis, prognosis, and measurements of diastolic function. Circulation. 2002;105:1387-93.

VanKraaij DJ, Van pol PE, Ruiters AW, De Swart JB, Lips DJ, Lencer N et al. Diagnosing diastolic heart failure. Eur J Heart Failure. 2002;4:427.

Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation. 1998;98:2282-9.

Ahmed A, Nanda NC, Weaver MT, Allman RM, DeLong JF. Clinical correlates of isolated left ventricular DD among hospitalized older heart failure patients. Am J Geriatr Cardiol. 2003;12:82-9.

Benjamin EJ, Levy D, Anderson KM, Wolf PA, Plehn JF, Evans JC et al. Determinants of doppler indexes of left ventricular diastolic function in normal subjects. The Framingham Heart Study. AM J Cardiol. 1992;70;508-15.

Rovner A, Fuentes LDL, Waggoner AD, Memon N, Chohan R, Roman DVG. Characterisation of left ventricular diastolic function in hypertension by use of doppler tissue imaging and color M-mode techniques. J Am Soc Echocardiogr. 2006;19:872-79.

Stoddard MF, Pearson AC, Kern MJ, Ratcliff J, Mrosec DJ, Labovitz AJ. Left ventricular diastolic function: Comparison of pulsed doppler echocardiographic and hemodynamic indexes in subjects with and without coronary heart disease. J Am Coll Cardiol. 1989;13(2):327-36.