CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 3, May/June 2011
AFRICA
127
sure and volume changes in hypertension, with the aim of main-
taining normal function. The early phases of altered geometry
are associated with compensated left ventricular function to a
near-normal level. This study revealed that the Tei index was
significantly higher among hypertensive subjects with concentric
hypertrophy compared to those with concentric remodelling.
Concentric hypertrophy has been associated with an increase
in cardiovascular events associated with systolic and diastolic
dysfunction in various studies.
8,9,12
The Tei index was similar
between hypertensive subjects with concentric hypertrophy and
those with eccentric hypertrophy. In some studies, concentric and
eccentric hypertrophy have been shown to bemore associatedwith
impaired diastolic function than with concentric remodelling.
22,23
Other studies have reported the relationship between left
ventricular geometry and systolic function in other popula-
tions.
4,8,12
Yilmaz
et al
. reported in 2004 that the systolic and
diastolic LV functions (using Tei index of myocardial perfor-
mance) were impaired in all subgroups of hypertensive patients
according to their left ventricle geometry compared to the
control group. This impairment was more advanced in patients
with concentric hypertrophy than in those with other LV geomet-
ric patterns.
24
Therefore, it can be concluded that abnormal left
ventricular geometric adaptation to hypertension is associated
with systolic and diastolic dysfunctions, which are reflected
accurately by the Tei index of myocardial performance among
hypertensive Nigerian subjects.
In terms of the limitations of this study, it does not provide
any information on the prognostic potential of the Tei index
among hypertensive subjects. Therefore, a prospective study to
determine the prognostic potential of the Tei index among black
hypertensive subjects would be relevant. Also, the impact of
antihypertensive therapy on the Tei index was not studied. It has
been shown that the Tei index is able to detect improvement in
systolic function in heart failure patients using carvedilol, and
improvement in systolic function in subjects with acute myocar-
dial infarction.
25-27
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