G Tissera1, Daniel Piskorz2,3, L Citta4, N Citta4, P Citta4, L Keller4, L Bongarzoni4, L Mata4, A Tommasi5. 1. Centenario National Hospital, Urquiza 3000, 2000, Rosario, Argentina. 2. Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina. danielpiskorz@ciudad.com.ar. 3. Cardiovascular Research Center Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina. danielpiskorz@ciudad.com.ar. 4. Cardiology Institute Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina. 5. Cardiovascular Research Center Sanatorio Británico SA, Paraguay 40, 2000, Rosario, Argentina.
Abstract
INTRODUCTION: LV dysfunction develops early in hypertension, even previously to left ventricular remodeling. AIMS: 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. STATISTICAL ANALYSIS: 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.
INTRODUCTION:LV dysfunction develops early in hypertension, even previously to left ventricular remodeling. AIMS: 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. STATISTICAL ANALYSIS: 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.
Entities:
Keywords:
Case control study; Hypertension; Left ventricular dysfunction; Modified Tei index
Authors: Richard Müller-Brunotte; Thomas Kahan; Karin Malmqvist; Margareta Ring; Magnus Edner Journal: Am J Hypertens Date: 2006-09 Impact factor: 2.689
Authors: Roberto M Lang; Michelle Bierig; Richard B Devereux; Frank A Flachskampf; Elyse Foster; Patricia A Pellikka; Michael H Picard; Mary J Roman; James Seward; Jack S Shanewise; Scott D Solomon; Kirk T Spencer; Martin St John Sutton; William J Stewart Journal: J Am Soc Echocardiogr Date: 2005-12 Impact factor: 5.251
Authors: Sherif F Nagueh; Christopher P Appleton; Thierry C Gillebert; Paolo N Marino; Jae K Oh; Otto A Smiseth; Alan D Waggoner; Frank A Flachskampf; Patricia A Pellikka; Arturo Evangelista Journal: J Am Soc Echocardiogr Date: 2009-02 Impact factor: 5.251
Authors: Garvan C Kane; Barry L Karon; Douglas W Mahoney; Margaret M Redfield; Veronique L Roger; John C Burnett; Steven J Jacobsen; Richard J Rodeheffer Journal: JAMA Date: 2011-08-24 Impact factor: 56.272
Authors: Onur Kaypakli; Mustafa Gür; Mehmet Yavuz Gözükara; Hakan Uçar; Ali Kivrak; Taner Şeker; Durmuş Yildiray Şahin; Zafer Elbasan; Caner Türkoğlu; Murat Çayli Journal: Herz Date: 2015-06-19 Impact factor: 1.443
Authors: Andrew S P Sharp; Robyn J Tapp; Simon A McG Thom; Darrel P Francis; Alun D Hughes; Alice V Stanton; Andrew Zambanini; Eoin O'Brien; Nish Chaturvedi; Simon Lyons; Sheila Byrd; Neil R Poulter; Peter S Sever; Jamil Mayet Journal: Eur Heart J Date: 2009-11-26 Impact factor: 29.983