Evaluation Of The Left Ventricular Systolic And Diastolic Function By The Tissue Doppler Imaging In Essential Hypertensive Patients With Different Left Ventricular Geometry

Objective:Several indexes such as the Tei index and the systolic mitral annular velocities were measured,to evaluate the clinical value of the Tissue Doppler Imaging in assessing the left ventricular systolic and diastolic function of the essential hypertensive patients with different left ventricular geometry.Method:212 patients with essential hypertension were enrolled,and 108 patients were men with the mean age of 56.4.According to the Ganau categories,all the patients were divided into two groups:group 1 or no left ventricular hypertrophy group(normal left ventricle geometric model group)had 108 patients(57 men with the mean age of 55.7);group 2 or left ventricular hypertrophy group(concentric remodeling group) had 104patients(58 men with the mean age of 57.3);80normal individuals(43 men with the mean age of 55.1)were enrolled as the control group.All patients were evaluated by two-dimensional,pulsed wave Doppler,and TDI echocardiography. Record and measure the inter-ventricular septum diameter(IVSd),left ventricular posterior wall diameter(LVPWd),left ventricular diastolic diameter(LVDd),the LV ejection fraction(LVEF)and the E/A ratio by the method the ASE recommended. From the apical four-chamber and two-chamber view,the Doppler sample volume was placed at the septum,lateral wall,inferior wall and anterior wall of the mitral annulus.Measure the Ea/Aa ratio,the systolic mitral annular velocities(Sa),the mean of the systolic mitral annular velocities(Sm),and the Tei index.Results:1.The change of the E/A ratio is the same with that of the Ea/Aa ratio.E/A＞1 (control group),E/A＜1(group 1),E/A＜1(group 2).E/A ratio fell off gradually in three groups,and there is significant difference between the controls and the hypertensive groups(p＜0.01).2.The Tei index in group 1(0.469±0.022)and group 2(0.518±0.034)is higher than that in control group(0.362±0.023)(p＜0.01),and so is the IVRT.There is no significant difference comparing the Tei index in the septum,lateral,anterior and inferior wall of the mitral annulus3.The Sm value fell off gradually in three group(p＜0.01).Conclusion:1.The Sm value is more morning,sensitive,and accurate than the LVEF in reflecting the LV systolic function. 2.As a new index,the Tei index can evaluate the global function of the left ventricle.The Tei index is convenient,sensitive,comprehends,not easily interfered,and well repeated.3.The Tei indexes in four walls of the mitral annular are different.Because the measurement error is significant if choosing only one wall,it is better to measure several walls and get mean of them.The results show that the Tei indexes in left ventricular anterior and inferior wall are more representative(closer to the mean) than those in the septum and the lateral wall,so both the walls are better choose if the single wall measurement is necessary.In the practice,the single wall measurement of the Tei index could be used in normal individuals and hypertensive patients to make the measurement more convenient.