[Diagnostic blood flow changes in the outflow tract of the left ventricle. A Doppler echocardiography study of arterial hypertension].

In patients with arterial hypertension we analyzed left ventricular filling by pulsed wave (PW) Doppler in the left ventricular inflow and outflow tract (LVIT and LVOT resp.). Separately, we determined the optimal position of flow analysis within the LVOT. We investigated 20 normals (N) and 37 patients with hypertension present for more than 1 year and consistently above 160/95 mm Hg. There was no evidence of other diseases. Echocardiographic signs of left ventricular hypertrophy were present in 20 (H1) and absent in 17 patients (H2). The mean age was 50 years in all groups. We analyzed the velocities (V) and velocity time integrals (F) of the E- and A-waves, respectively, as well as their ratios [E-wave (Ve,Fe), A-wave (Va,Fa), Ve/Va, Fe/Fa]. In the LVOT, we determined the end-diastolic A*-wave (A-wave propagated from LVIT to LVOT) and the S-wave (systolic flow) [A*-wave (Va*,Fa*), S-wave (Vs,Fs), Va*/Vs, Fa*/Fs]. Altered flow patterns were detected more sensitively in the LVOT as compared to the LVIT, even without detectable hypertrophy: In the LVIT Va was significantly different in H1 as compared to N (0.62 +/- 0.15 m/s in H1 vs. 0.52 +/- 0.13 m/s in N; p < 0.05), while H2 and N were comparable. For Ve/Va the same results were obtained (0.97 +/- 0.33 in H1 vs. 1.29 +/- 0.40 in N; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)