Division of Cardiology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria; Cardiology Clinic, Eberhards Karls University, Tubingen, Germany
Akintunde, A.A., Division of Cardiology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria, Cardiology Clinic, Eberhards Karls University, Tubingen, Germany; Akinwusi, P.O., Division of Cardiology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria; Opadijo, G.O., Division of Cardiology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
Introduction: Left ventricular geometry is associated with cardiovascular events and prognosis. The Tei index of myocardial performance is a combined index of systolic and diastolic dysfunction and has been shown to be a predictor of cardiovascular outcome in heart diseases. The relationship between the Tei index and left ventricular geometry has not been well studied. This study examined the association between the Tei index and left ventricular geometry among hypertensive Nigerian subjects. Methods: We performed echocardiography on 164 hypertensives and 64 control subjects. They were grouped into four geometric patterns based on left ventricular mass and relative wall thickness. The Tei index was obtained from the summation of the isovolumic relaxation time and the isovolumic contraction time, divided by the ejection time. Statistical analysis was done using SPSS 16.0. Results: Among the hypertensive subjects, 68 (41.4%) had concentric hypertrophy, 43 (26.2%) had concentric remodelling, 24 (14.6%) had eccentric hypertrophy, and 29 (17.7%) had normal geometry. The Tei index was significantly higher among the hypertensives with concentric hypertrophy (CH), concentric remodelling (CR) and eccentric hypertrophy (EH) compared to the hypertensives with normal geometry (0.83 ± 1.0, 0.71 ± 0.2, 0.80 ± 0.2 vs 0.61 ± 0.2, respectively). The Tei index was higher among hypertensives with CH and EH than those with CR. Stepwise regression analysis showed that the Tei index was related to ejection fraction, fractional shortening and mitral E/A ratio. Conclusion: Among Nigerian hypertensives, LV systolic and diastolic functions (using the Tei index) were impaired in all subgroups of hypertensive patients according to their left ventricle geometry compared to the control group. This impairment was more advanced in patients with concentric and eccentric hypertrophy.
adult; aged; article; blood pressure measurement; body height; body mass; cardiovascular parameters; comparative study; controlled study; diastolic blood pressure; diastolic dysfunction; echocardiography; female; heart contraction; heart disease; heart left ventricle; heart left ventricle ejection time; heart left ventricle hypertrophy; heart left ventricle mass; heart performance; human; hypertension; hypertrophy; interventricular septal thickness in diastole; left ventricle geometry; left ventricular internal dimension in diastole; left ventricular internal dimension in systole; major clinical study; male; outcome assessment; posterior wall thickness in diastole; relative wall thickness; relaxation time; systolic blood pressure; systolic dysfunction; Tei index; transthoracic echocardiography; Adult; Aged; Cardiovascular Diseases; Female; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Middle Aged; Nigeria; Risk Assessment; Ventricular Dysfunction, Left; Ventricular Remodeling