The Effect of Left Ventricular Geometry on Myocardial Performance Index in Hypertensive Patients

Abstract

Background: The relationship between Tei Index (TI) and left ventricular (LV) geometric patterns has not been previously well described. The present study therefore set out to describe the nature of this relationship. This study examined the association between the Tei index and left ventricular geometry among hypertensive Egyptian subjects. Methods: This study included 70 subjects (60 hypertensive Patients and 10 control subjects). Hypertensive Patients and control subjects were referred from outpatient clinic to the Echocardiographic laboratory of Cardiovascular Department in Almataria Teaching Hospital between April 2017-November 2017. TI was defined as the sum of isovolumic contraction and relaxation times divided by the ejection time, and values of LV TI<0.40 were considered normal, while higher values were considered abnormal. Four patterns of LV geometry (normal, concentric remodeling, concentric LV hypertrophy and eccentric LV hypertrophy) were determined from the LV mass index and LV relative wall thickness. Statistical analysis was done using SPSS version 20.0. Bivariate correlation and stepwise multiple linear regressions were used to analyze the associations between TI and a number of variables. Results: Among the hypertensive subjects, Concentric hypertrophy was the commonest pattern of abnormal geometry (36.7%), followed by eccentric hypertrophy (20%), and concentric remodeling was demonstrated in 15% of the hypertensive population. Only 28.3% of the hypertensive population had normal geometry. Hypertensive patients with normal geometry had the highest Tei index. Those with concentric hypertrophy had higher Tei index than those with concentric remodelling. However, there was no significant difference in the Tei index between those with eccentric and concentric hypertrophy. In correlation between MPI and Echocardiography variables of LVH of hypertensive patients in bivariate correlation had a direct statistically significant with LVPWDd, IVSDd, LVIDd, LVISd, LV mass & LVMI. The MPI had inverse significant correlation with EF and FS. While by using stepwise multiple linear regressions the predictor of MPI was the LV mass index. Conclusion: This study has found that MPI is impaired in hypertensive patients before development of ventricular hypertrophy and in left ventricular hypertrophy is more prominent in concentric hypertrophy.