Left ventricular diastolic function in hypertensive patients

Left ventricular filling rate has been shown to be depressed in hypertensive patients before any alteration in indexes of systolic function. The mechanism(s) underlying this abnormality is not known. However, several factors were found to influence left ventricular filling rate. The relative importance of these factors is emerging from studies performed at various centers. Of these, theadrenergic drive, coronary blood flow, heart rate, afterload, and calcium reuptake mechanisms seem to be important. Physiologically, the index of left ventricular filling should therefore be normalized to allow comparison between different individuals. Using a normalized index (filling rate/emptying rate), we found in a small group (n = 13) of hypertensive patients that the increase in total peripheral resistance during head-up tilt was blunted in those with reduced left ventricular filling, suggesting that this abnormality in diastolic function accompanying hypertension plays a role in cardiovascular regulation by altering sensitivity of cardiopulmonary reflexes.