title: Left ventricular dysfunction assessed by cardiac time interval analysis among different geometric patterns in untreated hypertension.
abstract: BACKGROUND
  Left ventricular (LV) hypertrophy is a powerful independent predictor of morbidity and mortality in hypertensive patients. Abnormal LV geometric patterns are also associated with hypertensive complications, and concentric hypertrophy is associated with the highest mortality in hypertensive patients. However, the relationship between geometric patterns and cardiac dysfunction is not fully established. We hypothesized that the Tei index, which is a measure of global cardiac function, is a feasible parameter for estimating cardiac dysfunction among the different LV geometric patterns in hypertensive patients.
  
  
  RESULTS
  We enrolled 60 consecutive patients with untreated essential hypertension. Subjects were divided into 4 groups: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. We measured ejection fraction, mitral E/A ratio, Tei index, ejection time, and isovolumic contraction and relaxation times. There were significant correlations between LV mass index and systolic blood pressure (P<0.01), ejection fraction (P<0.05), mitral E/A ratio (P<0.05) and Tei index (P<0.0001). In multiple regression analysis, only the Tei index independently correlated with LV mass index (P<0.01). Concentric hypertrophy significantly increased the Tei index compared with the other 3 groups.
  
  
  CONCLUSIONS
  The Tei index provides a better marker for LV dysfunction by hypertensive hypertrophy than conventional parameters. LV function in concentric hypertrophy was most impaired among all the geometric patterns in untreated hypertensive patients.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Masakazu
authors.initials: M
authors.lastname: Imamura
authors.forename: Toshinori
authors.initials: T
authors.lastname: Yuasa
authors.forename: Eiji
authors.initials: E
authors.lastname: Kuwahara
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kubota
authors.forename: Mihoko
authors.initials: M
authors.lastname: Kono
authors.forename: Nami
authors.initials: N
authors.lastname: Ueya
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Horizoe
authors.forename: Hideto
authors.initials: H
authors.lastname: Chaen
authors.forename: Naoko
authors.initials: N
authors.lastname: Mizukami
authors.forename: Akira
authors.initials: A
authors.lastname: Kisanuki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000704:Analysis of Variance; D001794:Blood Pressure; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling