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Background  We 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 Results  In 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.    Conclusion  The 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.

journal of the american heart association

Cardiac Time Intervals Measured by Tissue Doppler Imaging M‐mode: Association With Hypertension, Left Ventricular Geometry, and Future Ischemic Cardiovascular Diseases