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. 2016 Mar;29(3):379-87.
doi: 10.1093/ajh/hpv123. Epub 2015 Aug 12.

Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension

Monesha Gupta-Malhotra  1 , Rabih K Hamzeh  2 , Tim Poffenbarger  3 , Karen McNiece-Redwine  4 , Syed Shahrukh Hashmi  5
Affiliations

Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension

Monesha Gupta-Malhotra et al. Am J Hypertens. 2016 Mar.

Abstract

Background: As a global measure of ventricular systolic and diastolic function, the myocardial performance index (MPI) can be an early indicator of hypertensive cardiomyopathy in children with essential hypertension (EH).

Methods: Children with untreated newly diagnosed EH and white coat hypertension (WCH) by a 24-hour ambulatory blood pressure monitoring (ABPM), both groups without any identifiable etiology for the hypertension, were enrolled for the study. Echocardiograms and vascular ultrasounds for carotid artery intimal medial thickness were performed on all children prior to therapy. Diastolic function (peak E and A velocities, E/A ratio, isovolumic relaxation time, and deceleration times) and MPI were evaluated by simultaneous transmitral and transaortic spectral Doppler flow velocities. Systolic function was evaluated by shortening fraction and ejection fraction.

Results: A cohort of 66 children (24 with EH, 42 with WCH, males 61%, median age of 13 years, range 10-17 years) were enrolled in the study. The demographic, anthropometric, laboratory tests, vascular ultrasound, and conventional echocardiographic parameters were similar between the 2 groups. There was a very small difference in MPI between the EH and WCH children (0.28 SD: 0.07 vs. 0.31 SD: 0.08, P = 0.045). However, in EH children, MPI increased by 0.14 units for every 10 unit increase in mean ABPM systolic BP (95% confidence interval: 0.03-0.25).

Conclusions: We found the increasing MPI was associated with increasing 24-hour mean systolic BP in children with EH. Therefore, MPI may have utility as a single, quick, noninvasive method of detection and tracking of subclinical hypertensive heart disease.

Keywords: Tei index.; blood pressure; carotid intimal medial thickness; diastolic function; echocardiogram; hypertension; left ventricular hypertrophy; systolic function.

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Figures

Figure 1.
Figure 1.
Correlation of the myocardial performance index with 24-hour ambulatory systolic (A) and diastolic (B) blood pressure among children with white coat hypertension and essential hypertension.
See this image and copyright information in PMC

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