Abstract
A2 D time, a time interval from aortic second heart sound to the D point of mitral valve echogram, was reported as a valuable index of the left ventricular relaxation in its early diastole. It was suggested, however, that A2D time is influenced by variable factors rather than single factor.
This study was performed to evaluate the influences of several on the A2D time and to extend our understandings in A2D time. For this purpose, A2D time was measured in 4 groups whose hemodynamic states were different, i.e.31 normal subjects (group A), 32 patients with essential hypertension without decompensation (group B), 10 normotensive patients with clinically full blown congestive heart failure (group C), and 11 patients with hypertensive heart failure (group D), and the mean values of each group were compared between the groups. Concordantly systolic hemodynamic parameters were observed and the relationship of A2D time and each of these parameters were observed. A2D time was consistently influenced by the level of left ventricle impedance and it is well correlated with parameters representing left ventricular systolic performances. In hypertensive subiects, A2D time was increased before the deterioration of the left ventricular systolic function but shortened after clinical heart failure.
These findings suggest that A2D time may be of value in longitudinal follow-up of the left ventricular function in the hypertensive patients even before the development of clinical heart failure.