Independent Determinants of the Tei Index in Hypertensive Patients With Preserved Left Ventricular Systolic Function
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概要
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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 ≥ 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 (β coefficient = -0.315, P < 0.001) and relative wall thickness (β 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.
著者
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Noma Takahisa
Department Of Cardiorenal And Cerebrovascular Medicine Kagawa University
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Goda Fuminori
Department Of Integrated Medicine Kagawa University
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YAMAGAMI Ayumu
Department of Integrated Medicine, Kagawa University
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Yukiiri Kazushi
Department Of Cardiorenal And Cerebrovascular Medicine Kagawa University
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Senda Shoichi
Department Of Integrated Medicine Kagawa University
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Kohno Takeaki
Department Of Integrated Medicine Kagawa University
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Yamagami Ayumu
Department Of Integrated Medicine Kagawa University
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Nishiyama Akira
Department Of Pharmacology Faculty Of Medicine Kagawa University
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Okuyama Hiroyuki
Department Of Integrated Medicine Kagawa University
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Hosomi Naohisa
Department Of Cardiorenal And Cerebrovascular Medicine Kagawa University
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Masugata Hisashi
Department Of Cardiology Ehime Prefectural Imabari Hospital
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Murao Koji
Division Of Endocrinology And Metabolism Department Of Internal Medicine Faculty Of Medicine Kagawa
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Noma Takahisa
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
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Hosomi Naohisa
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
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