Abstract 2286: Pseudonormalization Tendency of the Tei Index at High Filling Pressures -A Serious Limitation for its Use as a Myocardial Performance Index

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michael Dandel ◽  
Hans Lehmkuhl ◽  
Dagmar Kemper ◽  
Roland Hetzer

Background: The potential advantage provided by the combination of systolic and diastolic parameters makes the Tei index (myocardial performance index) attractive. This index is prolonged during mild or moderate left ventricular (LV) systolic dysfunction. The influence of diastolic dysfunction is unclear. We assessed the reliability of the Tei index for the evaluation of LV dysfunction, in relation to the severity of systolic and/or diastolic impairment. Methods: To evaluate the systolic LV dysfunction associated with various degrees of diastolic dysfunction by the Tei index, the isovolumetric contraction and relaxation time (IVCT and IVRT) and the ejection time were measured by continuous wave Doppler in 155 consecutive patients accepted for heart transplantation (HTx) because of advanced dilated cardiomyopathy (DCM). To evaluate the diastolic dysfunction by the Tei index, the same Doppler measurements were performed in 200 HTx patients who showed isolated diastolic LV dysfunction with normal ejection fraction (LVEF ≥ 55%). Results: Although the Tei index was prolonged (0.67 ±0.16) in DCM patients, there was no correlation between LVEF and Tei index. The Tei index was even lower in NYHA IV in comparison to NYHA II–III patients (0.56 ±0.11 vs. 0.76 ±0.14; p <0.001)). The LVEF was 17.5 ±5% in NYHA IV and 27.2 ±6% in NYHA II–III patients (p <0.01). The IVRT was shorter (p<0.001) in NYHA IV (60.8 ±13 ms) than in NYHA II–III patients (113.9 ±19.5 ms). After HTx, due to initially prolonged IVRT, the Tei index was higher before than after the 1 st post-HTx year (0.54 ±0.08 vs. 0.45 ±0.08; p<0.01). The Tei index was also lower (p<0.05) in patients with coronary allograft vasculopathy (CAV), than in those without (0.42 ±0.10 vs. 0.48 ±0.09). For both DCM and HTx patients there was a correlation between IVRT and Tei index (p <0.001; r = 0.71 and r =0.72, respectively) and also between LV enddiastolic pressure and Tei index (p <0.001; r = −0.69 and r = −0.74, respectively). Conclusions: The shortening of the IVRT due to the elevation of filling pressures in both severe systolic dysfunction (i.e. advanced DCM) and isolated diastolic dysfunction (post-HTx CAV) lowers the Tei index (pseudo-normalization tendency) and thus, in these clinical situations, the Tei index becomes misleading.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alper Akın ◽  
Edip Unal ◽  
Ruken Yildirim ◽  
Mehmet Ture ◽  
Hasan Balik ◽  
...  

AbstractSubclinical hypothyroidism (SH) may influence both ventricular functions. The aim of this study was to evaluation the findings of Tissue Doppler Imaging (TDI) and other echocardiography modalities in children with SH. We compared left ventricular mass index (LVMI) and TDI parameters of patients with SH and children with euthyroidism. Subclinical hypothyroidism was diagnosed when thyroid stimulating hormone level was higher than the reference value of the laboratory (> 4.2 mIU/L) and free thyroxine level was in normal range. The study included a group of 35 patients with SH and a control group of 38 children with euthyroidism (mean age was 7.6 ± 3.5 years and 9.0 ± 2.4 years, respectively). LVMI was significantly higher in the patient group (p = 0.005). TDI parameters including mitral septal ejection time was lower (p = 0.003) and mitral septal myocardial performance index was higher (p = 0.009) in the patient group. Right ventricular TDI revealed that tricuspid lateral E/Ea and tricuspid septal E/Ea were higher (p = 0.015 and p = 0.024, respectively) and tricuspid septal Ea/Aa and ejection time were lower (p = 0.018 and p = 0.017, respectively) in the patient group. SH may lead to increase LVMI. Left ventricular systolic and diastolic TDI parameters (lower mitral septal ejection time, higher mitral septal myocardial performance index) as well as right ventricular systolic (lower tricuspid septal ejection time) and diastolic (higher tricuspid septal and lateral E/Ea, lower tricuspid septal Ea/Ea) functions may be also impaired in children with subclinical hypothyroidism. TDI is a useful method used for the assessment of the effect of SH on cardiac functions.


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 358
Author(s):  
Su-Min Kim ◽  
Soo-Young Ye

The myocardial performance index is widely used as an indicator of the heart’s performance. However, due to the subjective nature of ultrasonic testing, there are differences in the measurements among inspectors, requiring a quantitative and objective assessment. In this study, an automated program was developed to quantitatively evaluate the myocardial performance index (MPI) and the cardiac time intervals in the left ventricle for each trimester. One hundred and thirty-three pregnant women who visited the hospital for prenatal examinations were studied, and skilled inspectors obtained left ventricular blood flow waveforms from 47 fetuses in the 12 weeks, 54 fetuses in the 22 weeks, and 32 fetuses in the 31 weeks of pregnancy using a pulse Doppler mode of ultrasound equipment. The acquired images automatically measured the isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT,) ejection time (ET), and filling time (FT), and calculated the Tei index (TI) and the K-index (KI); each interval was manually measured during the actual inspection for comparison. In this study, the ultrasonic Doppler waveform was objectively analyzed and measured by the automated program, and it will help with the evaluation of fetal heart function.


2010 ◽  
Vol 63 (9-10) ◽  
pp. 652-655 ◽  
Author(s):  
Vera Celic ◽  
Milica Dekleva ◽  
Anka Majstorovic ◽  
Nenad Radivojevic ◽  
Nada Kostic ◽  
...  

Introduction. Dynamic changing of left ventricular geometry and contractile state after acute myocardial infarction is responsible for various aspects of left ventricular remodeling and dysfunction. A number of studies have shown that myocardial performance index allows prediction of acute myocardial infarction complications. The objective of our study was to determine the power of myocardial performance index to predict and assess the severity of left ventricular remodeling, systolic and diastolic dysfunction after acute myocardial infarction over the long term. Material and methods. Echocardiography was performed within the first week of hospitalization, after one, three and six months in 77 patients with first acute myocardial infarction. At the end of the study the patients were divided into group A and B with mild and severe left ventricular remodeling, respectively. Results. Myocardial performance index was significantly lower in group A compared to B, at the beginning (0.62 vs. 0.75; p=0.002), and at the end of study (0, 60 vs. 0, 69; p=0.004). After six months, 31% of study patients developed LV systolic dysfunction with prevalence in group B (56% vs. 19%, p=0.002). Myocardial performance index ? 0.70 at first week after acute myocardial infarction is a strong predictive parameter for extensive early and late left ventricular remodeling and systolic dysfunction (p<0.05), but it is not a valuable predictor of diastolic failure. Discussion and conclusions. MPI obtained at first week of acute myocardial infarction was predictive for early and long term left ventricular remodeling and systolic dysfunction. Myocardial performance index had doubtful clinical use in assessing dynamics of remodeling and it was without clinical value in predicting diastolic function deterioration.


2005 ◽  
Vol 60 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Mustafa OZKAN ◽  
Mehmet UZUN ◽  
Kursad ERINC ◽  
Cem KOZ ◽  
Oben BAYSAN ◽  
...  

2012 ◽  
Vol 92 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Meric Kocaturk ◽  
Silvia Martinez ◽  
Oya Eralp ◽  
Asta Tvarijonaviciute ◽  
Jose Ceron ◽  
...  

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