Microalbuminuria and global myocardial function in patients with essential hypertensive P. Vyssoulis a , Eva A. Karpanou b , Andreas P. Michaelidis a , John D. Barbetseas a , Stella-Maria G. Kyvelou a, ⁎ , Theodoros P. Gialernios a , Dennis V. Cokkinos b , Christodoulos I. Stefanadis a a Hypertension Unit, 1st Cardiology Clinic Hippokration Hospital, Athens University, Greece b Hypertension Center, 1st Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece Received 28 September 2007; accepted 15 December 2007 Available online 1 April 2008 Abstract Introduction: The myocardial performance index, Tei index, is a relatively new echocardiography indice which is related to parameters which express both the systolic and diastolic myocardial function. The purpose of the present study was to investigate the possible correlation of Tei index to microalbuminuria, which is an indice of kidney target-organ damage in hypertensive patients. Materials and methods: We evaluated 9680 consecutive patients (mean age 55.2 years, 5144 male and 4536 female) with chronic uncomplicated essential hypertension and the correlation between Tei index, defined as the sum of the isovolumetric relaxation and contraction time divided by the ejection time, and kidney target damage (microalbuminuria) was evaluated. Results: In univariate analysis we noticed a positive correlation of Tei index with microalbuminuria (r = 0.353 p b 0.001). Furthermore, a significant difference was found in each Tei quartile for microalbumin levels (p b 0.001). In multivariate analysis with Tei index as a dependent variable (high versus low quartile) and independent variables gender, age, body mass index, plasma glucose, heart rate, blood pressure, kidney function indices and lipids, the independent prognostic correlation to microalbuminuria was noticed (ΟR: 1.002 p b 0.001). Conclusions: In the present study we found that Tei index correlates with microalbuminuria in essential hypertensive patients. Thus we can assume that this index could be used not only for the evaluation of the global myocardial performance of hypertensive patients but also for the assessment of the cardiovascular risk in arterial hypertension since it correlates with kidney damage. © 2008 Elsevier Ireland Ltd. All rights reserved. Keywords: Microalbuminuria; Tei index; Hypertension 1. Introduction The significance of target-organ damage in essential hypertensive patients is emphasized in the guidelines of the European Society of Hypertension [1]. The early diagnosis of organ damage with valid, non-invasive methods, plays a critical role in the stratification of the total cardiovascular risk and thus in the therapeutic approach of patients. Previous studies have shown that microalbuminuria is a prognostic marker of diabetic nephropathy, in diabetes mellitus type 1 and 2 [2], while it is considered as an independent predictor of both kidney and cardiovascular diseases. Moreover, in studies of non-diabetic hypertensive patients, microalbumin levels seem to be predictive of the future cardiovascular events [3–6]. Myocardial dysfunction seen in different cardiovascular diseases often is accompanied by both systolic and diastolic myocardial dysfunction. An invasive index which could evaluate both systolic and diastolic left ventricular function would have been a valuable diagnostic tool. Tei index is a simple, reproducible, and independent indice of ventricular geometry and it is not affected International Journal of Cardiology 126 (2008) 268 – 272 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Hypertension Unit, 1st Cardiology Clinic Hippokration Hospital, Athens University, V. Sofias 108 Ave, 11526, Greece. Τel.: +30 2107701950. E-mail address: kyvelou113@yahoo.g (S.-M.G. Kyvelou). 0167-5273/$ - see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2007.12.103