Assessment Of Left Ventricular Diastolic Function In Essential Hypertension With Left Ventricular Different Geometric Pattems By Tei Index

Objective:To explore the change of left ventricular diastolic function in patients with essential hypertention by Tei-index obtained from tissue Doppler imaging and to discuss the clinical value of Tei-index in assessment of left ventricular diastolic function in essential hypertension with left ventricular different geometric patterns.Methods:115/patients with essential hypertension were enrolled. According to Ganau categories, these patients were divided into four groups as follows: normal left ventricle(group1,36cases), concentric remodeling(group II,36cases), concentric hypertrophy(group III,31cases) and eccentric hypertrophy(group IV,12cases), and35age-matched healthy subjects as contral group were included. Interventricular septum end-diastole thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular end-diastolic dimension(LVEDD) were measured by M-mode ultrasonography. Using the Simpsons formula to measure left ventricular ejection fraction(LVEF).The mitral and pulmonary venous flow were measured by pulsed Doppler echocardiolgram including peak flow velocity of early diastole(E), peak flow velocity of atrial contraction(A), E/A ratio, the deceleration time of E(EDT), pulmonary venous flow velocity of systole(PVS), pulmonary venous flow velocity of diastole(PVD), PVS/PVD ratio. Tei index measured by tissue Doppler imaging.Result:1. Compared with control group, left ventricular diastolic function in hypertension were lower than of the normal.The E/A ratios<1of group I, II, III, and>1of group IV.In the I, II, III group, the EDT were higher than IV. LVEF in IV group was decreased, and has signicant deviation compared with contral group. 2. Tei-index of the hypertension group were increased than that of the normal. There was significant difference between group III and I. as well as between Groups IV and I, II, III.3. Left ventricular Tei-index were negatively correlated with LVEF and A. IVST, LVPWT, LVEDD, RWT, LVMI, E,E/A was positively correlated with that of the left ventricular respectively.4. Receiver operating characteristic curve (ROC) analysis for separation of the presence or absence of diastolic function insufficiency. The area under the receiver operating characteristic curve was0.986for the Tei-index. Using that cutpoint of Tei-index=0.425, diastolic function insufficiency was identified with a sensitivity of97%and a specificity of83%.Conclusion:1. Tei-index can evaluate left ventricular diastolic function of patients with essential hypertension.2. Left ventricular diastolic function in hypertension changed.The impairment degree of function was different in different patterns, among of them concentric hypertrophy and eccentric hypertrophy had the serious impairment.3. Tei-index were positive correlation with left ventricular different geometric patternsei of essential hypertension and diastolic function insufficiency, diastolic function of left ventricular was changed in the early stage, the more diastolic function is badly the more Tei index was higher.4. Tei-index is distinguish one of reference index of pseudonormal lization of mitral flow velocity curve pattern.