Comparison of simultaneous Doppler echo and apexcardiogram in detecting left ventricular diastolic dysfunction in patients with systemic hypertension.

Patient with systemic hypertension have often abnormalities of left ventricular (LV) diastolic function. Although pulsed Doppler echocardiography (PDE) is at present time the only simple widely used noninvasive method for evaluating such LV diastolic dysfunction, LV apexcardiogram (ACG) reflecting LV pressure curve changes can also be useful for evaluating LV diastolic events. In order to compare the validity of these two methods in assessing LV diastolic dysfunction, PDE and ACG were simultaneously obtained in 29 patients with chronic systemic hypertension and in 61 controls. As diastolic indices of PDE served the peak early (E) and late atrial (A) diastolic transmitral flow velocities, the A/E ratio and the deceleration time; and of the ACG the relative A-wave to total height (A/H), the total relaxation time (TART), the heart rate corrected TART and the combined index DATI (= diastolic amplitude time index). In patients with hypertension, from the PDE only A and A/E ratio were significantly different from the controls, whereas all mentioned ACG indices showed an abnormal mean value. Thus, the less widely used ACG appears to be a more accurate method in the noninvasive evaluation of diastolic mechanical events than the routinely used PDE in patients with chronic hypertension.