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(Hypertension. 1999;33:66-73.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Ultrasonic Myocardial Texture Versus Doppler Analysis in Hypertensive Heart

A Preliminary Study

Vitantonio Di Bello; Roberto Pedrinelli; Davide Giorgi; Alessio Bertini; Massimiliano Bianchi; Marco Paterni; Maria Francesca Romano; Giulia Dell'Omo; Costantino Giusti

From the Dipartimento di Medicina Interna (V. Di B., D.G., A.B., M.B., C.G.), Dipartimento di Cardiologia, Angiologia, e Pneumologia (R.P., G.D.), and Dipartimento di Matematica (M.F.R.), University of Pisa, and the Istituto di Fisiologia Clinica, CNR (M.P.), Pisa, Italy.

Correspondence to Vitantonio Di Bello, MD, Dipartimento di Medicina Interna, Universita' di Pisa, via Roma 67, 56100 Pisa, Italy. E-mail dibellov{at}po.ifc.pi.cnr.it

Abstract—Doppler-derived parameters of transmitral flow are useful indices of diastolic dysfunction in the hypertensive heart. Different degrees of myocardial involvement in hypertensive heart can be detected by videodensitometric myocardial textural analysis. The aim of this study was to compare Doppler-derived and ultrasonic videodensitometric parameters in the differentiation of healthy hearts from hypertensive hearts. We compared a group of age-matched (59±9 years) male essential hypertensive patients (n=53) with normotensive healthy subjects as controls (n=32). All subjects provided ambulatory blood pressure measurements for the evaluation of 24-hour mean systolic and diastolic blood pressure. A transmitral flow Doppler analysis was performed on all subjects. A quantitative analysis of the echocardiographic digitized imaging was performed with the help of a calibrated digitization system to calculate the septum and the posterior wall textural parameters. The myocardial mean gray level (MGL) was calculated to derive the cyclic variation index (CVI): (MGL_{end-diastolic}-MGL_end-systolic)/MGL_{end-diastolic}x100. When compared with controls, the hypertensive patients showed a significantly lower CVI for both septum (-11.1±26.8% versus 34.7±16.3%; P<0.001) and posterior wall (-11.2±27.6% versus 38.2±15.4%; P<0.001). Individual analyses for the ratio of peak transmitral flow velocity in early diastole to the peak transmitral flow velocity in late diastole showed that only 24% of the patients (13/53) were discriminated from normal subjects by this parameter. Individual analyses for CVI, however, at both septum and posterior wall levels, showed that 74% of the patients (39/53) were discriminated from normal subjects by this second parameter. In comparison with Doppler-derived indices of diastolic filling, the videodensitometric parameters showed a significantly higher ability to discriminate between hypertensive subjects and normal controls.

Key Words: hypertension, arterial • hypertrophy, left ventricular • ventricular function, left • echocardiography • ultrasonography

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