| Objective:The assessment of diastolic function is very important in order to get information relevant to patient functional class, management and diagnosis, It will also guides the clinician to understand the situation of the cardiac problem. If diastolic function is correctly assessed and manage at early time it can reduce the risk for subsequent cardiovascular morbid events. Therefore the purpose of this study is to evaluate myocardial function of our hypertensive patients with echocardiography and to contrast characteristics of parameters of conventional Doppler mitral flow and Doppler tissue imaging, and analyzing whether the degree of diastolic dysfunction is related to variant grade of hypertension.Methods.71 healthy subject as a control group including 37 male and 34 female age range 48.80?1.48 and hypertensive group (HBP), containing 59 male and 48 female age range 56.41111.61 was further divided into 3 subgroup according to blood pressure level (the patient blood pressure (BP) was recorded in the highest levels >2 times)Subgroup 1(gradel) SBP 140-159mmHg and/or DBP 90-99mmHg= 33cases Subgroup 2(grade2) SBP 160-179mmHg and- or DBP 100-109mmHg= 39cases Subgroup 3 (grade3) SBP > 180mmHg and/ or DBP > 1 lOmmHg =35 casesInclusion criteria: Essential hypertension one year and/or above with systolic blood pressure BP >140mmHg and'or diastolic blood pressure >90mmHg (BP140/90mmHg) and all subjects were in sinus rhythm.Exclusion criteria, we excluded secondary hypertension, appear coronary artery disease in clinical, atnal fibrillation, rapid heart rate, atrioventricular block, valvular heart disease, hypertrophy, restrictive and dilated cardiomyopathies, congenital heart disease and renal failure.1) Echocardiographic examinationTransthoracic echocardiographic examination were conducted the echocardiograms obtain with a 2.5 MHZ transducer. Echocardiograms recorded in left semi lateral decubitus position with subject breathing smoothly. ECG taken simultaneously. All measurements were carried at end expiration to minimize the effect of respiration.2.1) Two-dimensional Echocardiography:Two dimensional echocardiography were performed on each subjects, recording were taken in the parasternal long axis (plax), and the RV, LV internal dimension, interventricular septal, and posterior wall thicken at the end of diastole and LA at the end of the systole was measured according to the American society of Echocardiography guideline. In the Apical four-chamber view Ejection Fraction (EF) was calculated from the end-diastole and the end systole by using the single-plane formulate. (See fig 1)2.2) Doppler echocardiography:On the apical four chamber view, sample wave Doppler was set under the oriface of mitral leaflet at the end expiration stage to obtain the transmitral flow velocity and the following measurements were taken: MV-E, MV-A, VTIMV, VTIE, VTIA, DT-E.DCC-E, E/A. (see fig 2)2.3) Doppler tissue imaging:Using A4C view, To obtain mitral annulus velocity pulse wave Doppler tissue sample volume was place at the lateral of the mitral annulus (mitral outer annulus MOA) and at the septal of the mitral annulus (mitral inner annulus MIA)and the following parameter were measure in both annulus. DS, VS, E, A., VTIE, VTIA, E/A. (see fig 3)Results:In conventional Doppler and DTI recording were easily obtained from all hypertensive and control groupsIn systolic function from conventional parameter such as SV, SI, EF and aorta blood flow velocity, there are no differences between 4 clinical groups (control, grade 1, grade 2 and grade 3.)In diastolic function from conventional mitral blood flow peak E velocity (MV-E) of hypertensive patients are all lower than control group. Gradel E=66.73?3.59 VS 78.88 ?7.67 PO.05, Grade2 E=67.32 ?6.68 VS 78.88 ?17.67 P < 0.05 Grade3 E=65.25 ?15.36 VS 78.88 ?7.67 P<0.01 Peak A velocity (MV-A) of grade 2 is higher than control and grade 1. E velocity time integral (VTI-E) of hypertensive groups are all lower than cont...
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