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Abstract

It is known that left ventricular diastolic dysfunction is preliminary to systolic dysfunction in patients with essential hypertension (EH). The purpose of this study was to examine the relationship between the a Doppler-derived index (total ejection isovolume index: TEI index) of combined systolic and diastolic myocardial performance and neurohormonal effects or circadian blood pressure (BP) changes in patients with EH. We examined ambulatory 24-hour BP and echocardiography in 52 untreated patients with EH (53±2<SE> y; 30 men and 22 women). TEI index was univariately significantly related to nighttime mean BP (r=0.44, p<0.005) and left ventricular mass index (r=0.49, p<0.001). Furthermore, 20 inpatients (53±3 y; 15 men and 5 women) of 52 with EH were also examined plasma (PNE) and urinary norepinephrine (UNE), plasma renin activity (PRA), plasma aldosterone concentration (PAC) after ingested a diet of 7g salt (NaCl) per day for a week. By multiple regression analysis, TEI index was significantly related to PAC as an independent variable (R2=0.40, p<0.005) but not to nighttime mean BP, PRA, PNE, and UNE. Since TEI index was significantly related to nighttime mean BP, it was suggested that TEI index would be useful for an index of the severity of hypertensive target organ damage. Moreover, since TEI index was strongly related to PAC rather than BP, PAC might be correlated with both left ventricular systolic and diastolic function.

total ejection isovolume index, left ventricular hypertrophy, aldosterone
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© American Journal of Hypertension, Ltd. 2001
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