Masugata Hisashi, Senda Shoichi, Goda Fuminori, Yamagami Ayumu, Okuyama Hiroyuki, Kohno Takeaki, Hosomi Naohisa, Yukiiri Kazushi, Noma Takahisa, Murao Koji, Nishiyama Akira, Kohno Masakazu
Department of Integrated Medicine, Kagawa University, Kagawa, Japan.
Int Heart J. 2009 May;50(3):331-40. doi: 10.1536/ihj.50.331.
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 > or = 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 (beta coefficient = -0.315, P < 0.001) and relative wall thickness (beta 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.
反映左心室（LV）收缩和舒张功能的Tei指数的临床实用性，已知在患有明显心脏病如缺血性心脏病或充血性心力衰竭的患者中具有预后价值。此外，左心室舒张功能参数如二尖瓣E/A（早期与心房速度）比值已被证明在高血压患者中具有预后价值。然而，Tei指数在无明显心脏病的高血压患者中的临床实用性尚未得到充分研究。我们比较了高血压患者和血压正常患者的Tei指数，并研究了左心室收缩功能保留的高血压患者中Tei指数的独立决定因素。我们的研究对象是319例有心血管危险因素（包括高血压和糖尿病）的患者，他们的左心室收缩功能均保留（左心室射血分数≥55%）。他们被分为两组：100例血压正常者（67±11岁）和219例高血压患者（69±13岁）。使用多普勒超声心动图测量包括二尖瓣E/A比值和Tei指数在内的左心室结构和功能参数。在高血压患者的所有超声心动图参数中，二尖瓣E速度与Tei指数的相关性最密切（r = -0.311，P < 0.001）。逐步回归分析显示，E速度（β系数 = -0.315，P < 0.001）和相对室壁厚度（β系数 = 0.262，P < 0.001）与Tei指数独立相关。左心室收缩功能保留的高血压患者的Tei指数可能主要由舒张早期左心室舒张功能障碍伴左心室向心性重塑决定，并且可能与E/A比值一起在高血压患者中具有预后价值。
