Left Ventricular Dysfunction Assessed by Cardiac Time Interval Analysis Among Different Geometric Patterns in Untreated Hypertension

Kunitsugu Takasaki; Masaaki Miyata; Masakazu Imamura; Toshinori Yuasa; Eiji Kuwahara; Kayoko Kubota; Mihoko Kono; Nami Ueya; Yoshihisa Horizoe; Hideto Chaen; Naoko Mizukami; Akira Kisanuki; Shuichi Hamasaki; Chuwa Tei

doi:10.1253/circj.CJ-11-1369

Hypertension and Circulatory Control

Left Ventricular Dysfunction Assessed by Cardiac Time Interval Analysis Among Different Geometric Patterns in Untreated Hypertension

Kunitsugu Takasaki, Masaaki Miyata, Masakazu Imamura, Toshinori Yuasa, Eiji Kuwahara, Kayoko Kubota, Mihoko Kono, Nami Ueya, Yoshihisa Horizoe, Hideto Chaen, Naoko Mizukami, Akira Kisanuki, Shuichi Hamasaki, Chuwa Tei

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Kunitsugu Takasaki
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Masaaki Miyata
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Masakazu Imamura
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Toshinori Yuasa
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Eiji Kuwahara
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Kayoko Kubota
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Mihoko Kono
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Nami Ueya
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Yoshihisa Horizoe
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Hideto Chaen
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Naoko Mizukami
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Akira Kisanuki
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Shuichi Hamasaki
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Chuwa Tei
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

Keywords: Echocardiography, Hypertension, Left ventricular function, Left ventricular hypertrophy

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2012 Volume 76 Issue 6 Pages 1409-1414

DOI https://doi.org/10.1253/circj.CJ-11-1369

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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. Methods and 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. (Circ J 2012; 76: 1409-1414)

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