Abstract
To study the significance of left ventricular (LV) diastolic filling in elder patients with hypertension (HT), cardiac blood pool imagings with Tc-99m were obtained at rest in 17 normal subjects and 28 patients with systemic hypertension. The patients with hypertension did not show any evidence of coronary heart disease, renal insufficiency or other disease. Moreover, they showed normal LV ejection fraction (LVEF) and normal LV wall motion. They were divided into 4 groups: 1) normal-young (<60 years old, n=10), 2) normal-old (≥65 years old, n=7), 3) HT-young (<60 years old, n=15), 4) HT-old (≥65 years old, n=13). From the LV volume curve and its first differentiation curve, LVEF, mean first third ejection rate (ERm) and peak ejection rate (PER) were obtained as indices of the LV systolic function, and LV diastolic filling rate during the first third of diastole (FRm) and peak filling rate (PFR) were obtained as indices of LV diastolic function. All indices of LV systolic function were similar in all groups. In contrast, LV diastolic indices (FRm and PFR) of older groups were significantly lower than those of young groups both in HT and normal. Also, LV diastolic indices in HT groups decreased significantly in comparison with normal groups of the same age group. Among diastolic indices, FRm could distinguish patients with HT from normal subjects of the same age group more accurately than PFR. In normal subjects. FRm correlated with age (r=-0.490, p<0.05) and ERm (r=-0.489, p<0.05). In addition to age ERm, FRm correlated wit LV wall thickness measured by M-mode ecocardiograpy (r=-0.566, p<0.05) in patients with HT. In HT-old, the correlations between FRm and LV wall thickness and between FRm and ERm were more significant than in HT-young. These results suggested; 1) In elderly patients with HT, the impairment of early diastolic filling of LV was more prominent than in young patients with HT. 2) In elder patients with HT, LV diastolic abnormality was influenced more highly by the degree of LV hypertrophy than young patients with HT. 3) These diastolic abnormalities may cause systolic dysfunction in elderly patients with HT.
