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Early myocardial changes in normotensive children of hypertensive parents: a tissue Doppler study

Pelin Kosger1, Gokmen Ozdemir2, Ali Yildirim3

  • 1Department of Pediatric Cardiology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey. pelinkosger@mynet.com.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|September 1, 2018
PubMed

Insights

Children with hypertensive parents show early signs of heart changes. Tissue Doppler imaging (TDI) detected increased myocardial performance index (MPI) and wall thickness, indicating subclinical hypertension risk.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Echocardiography

Background:

  • Children of hypertensive parents (NCHP) are at increased risk for cardiovascular diseases.
  • Early detection of subclinical cardiac changes is crucial for timely intervention.
  • Normotensive children of hypertensive parents (NCHP) represent a key group for studying early cardiovascular alterations.

Purpose of the Study:

  • To investigate early left ventricular systolic and diastolic functional changes in NCHP using tissue Doppler imaging (TDI).
  • To assess the utility of the myocardial performance index (MPI) derived from TDI in identifying subclinical cardiac dysfunction in this at-risk pediatric population.

Main Methods:

  • A case-control study involving 92 NCHP and 90 matched normotensive children of normotensive parents (NCNP) aged 6-18 years.
  • Echocardiography including transmitral flow pulse wave Doppler and mitral septal/lateral annular TDI was performed.
  • Left ventricular systolic and diastolic function was evaluated using TDI-derived MPI, along with other standard echocardiographic parameters.

Main Results:

  • NCHP group exhibited higher blood pressure, increased interventricular septum and posterior wall thickness, and elevated transmitral flow A velocity compared to NCNP.
  • TDI revealed prolonged isovolumetric relaxation time and contraction time, shortened ejection time, and significantly increased MPI' in the NCHP group.
  • Increased MPI' correlated positively with systolic blood pressure and myocardial thickness, and negatively with ejection fraction and E/A ratio, suggesting diastolic dysfunction.

Conclusions:

  • Tissue Doppler imaging, particularly the myocardial performance index (MPI), effectively detects early subclinical left ventricular systolic and diastolic functional changes in children at familial risk of hypertension.
  • MPI' is a repeatable, non-invasive, and cost-effective tool for identifying children with potential early-stage hypertension.
  • These findings highlight the importance of regular cardiac screening in NCHP to prevent future cardiovascular events.

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