Morphologic and Functional Heart Abnormalities Associated to High Modified Tei Index in Hypertensive Patients.
BACKGROUND
LV dysfunction develops early in hypertension, even previously to left ventricular remodeling.


OBJECTIVE
To determine the frequency of morphologic and functional heart abnormalities associated to abnormal modified Tei Index in untreated hypertensive (HBP) patients (p) with preserved ejection fraction (pEF).


METHODS
Case-control study. Three groups: (1) HBP without left ventricular hypertrophy (LVH); (2) HBP with LVH; (3) non-HBP controls. Ejection fraction >54 % identified pEF. LVH measured by Devereux method. Systolic and diastolic functions assessed by standard echocardiography and tissue Doppler. 2013 ESH/ESC Hypertension Guidelines normal values were considered. Tei index measured at the lateral and septal LV walls in apical 4-chamber view by tissue Doppler, value >0.40 considered abnormal.


METHODS
multifactorial ANOVA test adjusted by sex and age, p < 0.05 statistically significant.


RESULTS
The study included 14 controls, 88 HBP p without LVH, and 19 HBP p with LVH. The HBP p sample mean age was 58.7 ± 13.5 years and 52 (44.1 %) were males. Mean Tei Index was 0.35 ± 0.03 in controls; 0.42 ± 0.05 in HBP without LVH; and 0.42 ± 0.06 in HBP with LVH (p < 0.025). Abnormal Tei Index was present in 2p (14.3 %) controls; 64 p (72.7 %) HBP without LVH; and 15 p (78.9 %) HBP with LVH (p < 0.0009). Tissue Doppler's wave was 8.4 ± 0.9 cm/s in controls; 8 ± 1.6 cm/s in HBP without LVH and 7.8 ± 1.1 cm/s in HBP with LVH.


CONCLUSIONS
(1) Left ventricular dysfunction is frequent in HBP p, even without LVH; (2) modified tissue Doppler Tei index is a useful tool for the diagnosis of left ventricular dysfunction.
Centenario National Hospital, Urquiza 3000, 2000, Rosario, Argentina.
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G
Tissera
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina. danielpiskorz@ciudad.com.ar.|Cardiovascular Research Center Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina. danielpiskorz@ciudad.com.ar.
Daniel
D
Piskorz
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
L
L
Citta
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
N
N
Citta
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
P
P
Citta
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
L
L
Keller
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
L
L
Bongarzoni
Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
L
L
Mata
Cardiovascular Research Center Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
A
A
Tommasi
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
Case control study; Hypertension; Left ventricular dysfunction; Modified Tei index