Diastolic left ventricular volume flow in patients with arterial hypertension before and following acute antihypertensive medication

: Parameters of diastolic left ventricular (LV) function were studied noninvasively in 15 hypertensive patients without coronary heart disease (HY) vs 15 age- and sex-matched normotensive controls (CO). The maximal mitral valve area (2-D-Mode), the diastolic change in mitral valve area (M-mode), and diastolic velocity profiles in the LV inflow tract (pw-Doppler) were obtained in each patient using echocardiography. In HY the early diastolic volume flow (371 +/- 125 vs 492 +/- 134 ml/s, p less than 0.01) and the early diastolic filling volume (38 +/- 12 vs 48 +/- 15 ml, p less than 0.0125) were significantly diminished compared to CO. However, the early diastolic maximal flow velocity was not altered due to a smaller maximal early diastolic mitral valve area. At the time of active filling, volume flow and filling volume in HY were not significantly increased, whereas--due to a smaller mitral valve area (5.8 +/- 1.4 vs 6.9 +/- 1.7 cm2, p less than 0.01)--maximal flow velocity was higher than in controls (65 +/- 20 vs 55 +/- 9 cm/s, p less than 0.05). One hour following oral medication of 20 mg nifedipine, diastolic wall stress dropped significantly in HY. The diastolic flow velocity, the volume flow, and the filling volume during rapid and active filling were unchanged. Conclusively, we found a drop in early diastolic volume flow and filling volume due to an alteration of relaxation in patients with hypertension. Acute pharmacological interventions leading to lowering of the arterial blood pressure and systolic wall stress do not reverse these alterations.(ABSTRACT TRUNCATED AT 250 WORDS)