title: Independent determinants of the Tei index in hypertensive patients with preserved left ventricular systolic function.
abstract: The clinical usefulness of the Tei index, which reflects left ventricular (LV) systolic and diastolic function, is known to have prognostic value in patients with overt heart disease such as ischemic heart disease or congestive heart failure. Additionally, LV diastolic functional parameters such as the transmitral E/A (early to atrial velocity) ratio have been shown to have prognostic value in hypertensive patients. However, the clinical usefulness of the Tei index for hypertensive patients without overt heart disease has not yet been fully studied. We compared the Tei index between hypertensive and normotensive patients and examined independent determinants of the Tei index in hypertensive patients with preserved LV systolic function. Our subjects were 319 patients with cardiovascular risk factors including hypertension and diabetes, all of whom had preserved LV systolic function (LV ejection fraction > or = 55%). They were divided into two groups: 100 normotensives (67 +/- 11 years) and 219 hypertensives (69 +/- 13 years). LV structural and functional parameters including transmitral E/A ratio and the Tei index were measured with Doppler echocardiography. The correlations of the transmitral E velocity to the Tei index (r = -0.311, P < 0.001) were the closest in all echocardiographic parameters in hypertensives. Stepwise regression analysis showed that E velocity (beta coefficient = -0.315, P < 0.001) and relative wall thickness (beta coefficient = 0.262, P < 0.001) were independently associated with the Tei index. The Tei index in hypertensives with preserved LV systolic function may be determined primarily by LV diastolic dysfunction during early diastole with LV concentric remodeling and may, together with the E/A ratio, have prognostic value in hypertensive patients.
authors.affiliation: Department of Integrated Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
authors.forename: Ayumu
authors.initials: A
authors.lastname: Yamagami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Takeaki
authors.initials: T
authors.lastname: Kohno
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.forename: Kazushi
authors.initials: K
authors.lastname: Yukiiri
authors.forename: Takahisa
authors.initials: T
authors.lastname: Noma
authors.forename: Koji
authors.initials: K
authors.lastname: Murao
authors.forename: Akira
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology*; D011379:Prognosis; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology; D055815:Young Adult