Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases
BackgroundWe hypothesized that the cardiac time intervals reveal reduced myocardial function in persons with hypertension and are strong predictors of future ischemic cardiovascular diseases in the general population. Methods and ResultsIn a large community‐based population study, cardiac function w...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.115.002687 |
| _version_ | 1818328026118619136 |
|---|---|
| author | Tor Biering‐Sørensen Rasmus Mogelvang Peter Schnohr Jan Skov Jensen |
| author_facet | Tor Biering‐Sørensen Rasmus Mogelvang Peter Schnohr Jan Skov Jensen |
| author_sort | Tor Biering‐Sørensen |
| collection | DOAJ |
| description | BackgroundWe hypothesized that the cardiac time intervals reveal reduced myocardial function in persons with hypertension and are strong predictors of future ischemic cardiovascular diseases in the general population. Methods and ResultsIn a large community‐based population study, cardiac function was evaluated in 1915 participants by using both conventional echocardiography and tissue Doppler imaging (TDI). The cardiac time intervals, including the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and ejection time (ET), were obtained by TDI M‐mode through the mitral leaflet. IVCT/ET, IVRT/ET, and myocardial performance index [MPI=(IVRT+IVCT)/ET] were calculated. After multivariable adjustment for clinical variables the IVRT, IVRT/ET, and MPI, remained significantly impaired in persons with hypertension (n=826) compared with participants without hypertension (n=1082). Additionally, they displayed a significant dose–response relationship, between increasing severity of elevated blood pressure and increasing left ventricular mass index (P<0.001 for all). Further, during follow‐up of a median of 10.7 years, 435 had an ischemic cardiovascular disease (ischemic heart disease, peripheral arterial disease, or stroke). The IVRT/ET and MPI were powerful and independent predictors of future cardiovascular disease, especially in participants with known hypertension. They provide prognostic information incremental to clinical variables from the Framingham Risk Score, the SCORE risk chart, and the European Society of Hypertension/European Society of Cardiology risk chart. ConclusionThe cardiac time intervals identify impaired cardiac function in individuals with hypertension, not only independent of conventional risk factors but also in participants with a normal conventional echocardiographic examination. The IVRT/ET and MPI are independent predictors of future cardiovascular disease especially in participants with known hypertension. |
| first_indexed | 2024-12-13T12:25:37Z |
| format | Article |
| id | doaj.art-290208045dcb4815b2e288273387097c |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T12:25:37Z |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-290208045dcb4815b2e288273387097c2022-12-21T23:46:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-01-015110.1161/JAHA.115.002687Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular DiseasesTor Biering‐Sørensen0Rasmus Mogelvang1Peter Schnohr2Jan Skov Jensen3Department of Cardiology, Herlev and Gentofte Hospital, DenmarkDepartment of Cardiology, Herlev and Gentofte Hospital, DenmarkThe Copenhagen City Heart Study, Bispebjerg Hospital, University of Copenhagen, DenmarkDepartment of Cardiology, Herlev and Gentofte Hospital, DenmarkBackgroundWe hypothesized that the cardiac time intervals reveal reduced myocardial function in persons with hypertension and are strong predictors of future ischemic cardiovascular diseases in the general population. Methods and ResultsIn a large community‐based population study, cardiac function was evaluated in 1915 participants by using both conventional echocardiography and tissue Doppler imaging (TDI). The cardiac time intervals, including the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and ejection time (ET), were obtained by TDI M‐mode through the mitral leaflet. IVCT/ET, IVRT/ET, and myocardial performance index [MPI=(IVRT+IVCT)/ET] were calculated. After multivariable adjustment for clinical variables the IVRT, IVRT/ET, and MPI, remained significantly impaired in persons with hypertension (n=826) compared with participants without hypertension (n=1082). Additionally, they displayed a significant dose–response relationship, between increasing severity of elevated blood pressure and increasing left ventricular mass index (P<0.001 for all). Further, during follow‐up of a median of 10.7 years, 435 had an ischemic cardiovascular disease (ischemic heart disease, peripheral arterial disease, or stroke). The IVRT/ET and MPI were powerful and independent predictors of future cardiovascular disease, especially in participants with known hypertension. They provide prognostic information incremental to clinical variables from the Framingham Risk Score, the SCORE risk chart, and the European Society of Hypertension/European Society of Cardiology risk chart. ConclusionThe cardiac time intervals identify impaired cardiac function in individuals with hypertension, not only independent of conventional risk factors but also in participants with a normal conventional echocardiographic examination. The IVRT/ET and MPI are independent predictors of future cardiovascular disease especially in participants with known hypertension.https://www.ahajournals.org/doi/10.1161/JAHA.115.002687cardiac time intervalshypertensionischemic cardiovascular diseaserisk‐stratificationtissue Doppler imaging |
| spellingShingle | Tor Biering‐Sørensen Rasmus Mogelvang Peter Schnohr Jan Skov Jensen Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac time intervals hypertension ischemic cardiovascular disease risk‐stratification tissue Doppler imaging |
| title | Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases |
| title_full | Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases |
| title_fullStr | Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases |
| title_full_unstemmed | Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases |
| title_short | Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases |
| title_sort | cardiac time intervals measured by tissue doppler imaging m mode association with hypertension left ventricular geometry and future ischemic cardiovascular diseases |
| topic | cardiac time intervals hypertension ischemic cardiovascular disease risk‐stratification tissue Doppler imaging |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.115.002687 |
| work_keys_str_mv | AT torbieringsørensen cardiactimeintervalsmeasuredbytissuedopplerimagingmmodeassociationwithhypertensionleftventriculargeometryandfutureischemiccardiovasculardiseases AT rasmusmogelvang cardiactimeintervalsmeasuredbytissuedopplerimagingmmodeassociationwithhypertensionleftventriculargeometryandfutureischemiccardiovasculardiseases AT peterschnohr cardiactimeintervalsmeasuredbytissuedopplerimagingmmodeassociationwithhypertensionleftventriculargeometryandfutureischemiccardiovasculardiseases AT janskovjensen cardiactimeintervalsmeasuredbytissuedopplerimagingmmodeassociationwithhypertensionleftventriculargeometryandfutureischemiccardiovasculardiseases |