Evaluatino of diastolic function reserve with exercise in herpytensive patient

Introduction: Diastolic function which appear in exercise is determined the complex interaction between increased sympathetic activation, tachycardia, increased preload and left ventricle diastolic filling time. Normal ventricle?s response to exercise is quick relaxation, and this results increased elastic relaxation. Stiff myocardium which shows relaxation failure in rest can not quicken the relaxation under hemodynamic stress of exercise which appears increased cardiac output, increased blood pressure and tachycardia. This condition causes marked increase at ventricular filling pressure. Consequently, the symptoms as dyspnea and tiredness arise with exercise in asymptomatic patients in rest.Purpose: To evaluate diastolic function parameters in hypertensive patients, to determine changes of these parameters after exercise, and the diastolic parameters before and after exercise comparison with effort capacity.Material and Method: 50 patients who were hypertensive and between the age of 30 and 70 were included in the study. They consist of 29 men (58%) and 21 women (%42). Patients who have Diabetes Mellitus, abnormal sinus rhythm, coronary artery disease, valve failure and regurgitation, prosthetic valve and renal failure were excluded from the study. After the evaluation of patients echocardiography in rest, diastolic function parameters were measured after exercise and compared with the results in rest.Results: Early diastolic flow rate after exercise was significantly higher than before exercise (0.76±0.11 m/sn vs 0.91±0.14 m/sn, p<0.0001),whereas there was no statistically significant differences between late diastolic flow rate after exercise and before exercise (0.75±0.14 m/sn vs 0.75±0.18 m/sn, p=0.77). Mitral diastolic flow E/A ratio was found significantly incerased (0.99±0.34 vs 1.34±0.55,p<0.0001). When compared the E/e? ratio, both mean values and measurement of lateral and septal zones showed statistically significant differences between the results of after exercise and in rest (p=0.0001). Statistically significant relationship was observed between Borg index and E/e? values which was measured in rest (r=0.285, p=0.001). Similarly, significant correlation was found between E/e? ratio after exercise (r=0.372, p=0.001).Results: This study shows that there is a close relationship between restricted effort capacity and diastolic dysfunction. Diastolic stress test is an easy test to apply in clinical practice and provides prognostic information about noninvasive evaluation of left ventricle filling pressure after exercise. Our study detected that E/e? ratio finding with diastolic stress test is a significant parameter to explain the dyspnea in hypertensive patients who have normal or slightly diastolic dysfunction.