scholarly journals Fetal cardiac function: myocardial performance index

2021 ◽  
Vol 18 ◽  
Author(s):  
Mariana Oliveira ◽  
Joana Portela Diasa ◽  
Luís Guedes- Martins
Keyword(s):  
Performance Index ◽  
Heart Function ◽  
Relevant Literature ◽  
Perinatal Outcomes ◽  
Maternal Diabetes ◽  
Myocardial Performance Index ◽  
Future Research ◽  
Myocardial Performance ◽  
Ejection Time ◽  
Adverse Perinatal Outcomes

Abstract: The Myocardial Performance Index (MPI) or Tei index, presented by Tei in 1995, is the ratio of the sum of the duration of the isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) to the duration of the ejection time (ET). The Modified Myocardial Performance Index (Mod-MPI), proposed in 2005, is considered a reliable and useful tool in the study of fetal heart function in several conditions, such as growth restriction, twin-twin transfusion syndrome, maternal diabetes, preeclampsia, intrahepatic cholestasis of pregnancy, and adverse perinatal outcomes. Nevertheless, clinical translation is currently limited by poorly standardised methodology as variations in the technique, machine settings, calliper placement, and specific training required can result in significantly different MPI values. This review aims to provide a survey of the relevant literature on MPI, present a strict methodology and technical considerations, and propose future research.

scholarly journals Evaluation of the Fetal Left Ventricular Myocardial Performance Index (MPI) by Using an Automated Measurement of Doppler Signals in Normal Pregnancies

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 358
Author(s):  
Su-Min Kim ◽  
Soo-Young Ye
Keyword(s):  
Performance Index ◽  
Heart Function ◽  
Objective Assessment ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Myocardial Performance ◽  
Ejection Time ◽  
Filling Time ◽  
Doppler Signals ◽  
Pulse Doppler

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.

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
Keyword(s):  
Diastolic Dysfunction ◽  
Performance Index ◽  
Continuous Wave ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Myocardial Performance ◽  
Tei Index ◽  
Ejection Time ◽  
Lv Dysfunction

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.

scholarly journals Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alper Akın ◽  
Edip Unal ◽  
Ruken Yildirim ◽  
Mehmet Ture ◽  
Hasan Balik ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Patient Group ◽  
Subclinical Hypothyroidism ◽  
Performance Index ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Doppler Imaging ◽  
Myocardial Performance ◽  
Ejection Time ◽  
Ventricular Functions

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.

scholarly journals The (Pulsed-Wave) Doppler Fetal Myocardial Performance Index: Technical Challenges, Clinical Applications and Future Research

2015 ◽  
Vol 38 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Aditi Mahajan ◽  
Amanda Henry ◽  
Neama Meriki ◽  
Edgar Hernandez-Andrade ◽  
Fatima Crispi ◽  
...  
Keyword(s):  
Performance Index ◽  
Myocardial Performance Index ◽  
Future Research ◽  
Reference Ranges ◽  
Myocardial Performance ◽  
Cardiac Strain ◽  
Highly Sensitive ◽  
Cardiovascular Assessment ◽  
Pulsed Wave Doppler ◽  
Parameter Measuring

Functional cardiovascular assessment is becoming an increasingly important tool in the study of fetal pathology. The myocardial performance index (MPI) is a parameter measuring global myocardial function. Since its introduction, several studies have proposed methods to improve its reproducibility and have constructed normative reference ranges. Fetal heart evaluation using the MPI is technically challenging, requiring specific training and expertise, and a consensus has yet to be reached on the method of delineating the time periods used to calculate the index. Despite these limitations, it has been shown to be a useful and highly sensitive parameter of dysfunction in a number of fetal pathologies. Further research is warranted into the effect of pathology on MPI, parameters of unilateral cardiac strain that utilise MPI, and automation of the MPI to encourage incorporation of the MPI as a useful tool in clinical practice.

scholarly journals Fetal myocardial index during labor

2016 ◽  
Vol 6 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Alexis C. Gimovsky ◽  
Brianne Whitney ◽  
Dennis Wood ◽  
Stuart Weiner
Keyword(s):  
Performance Index ◽  
Fetal Echocardiography ◽  
Myocardial Performance Index ◽  
University Hospital ◽  
Myocardial Performance ◽  
Third Trimester ◽  
Ejection Time ◽  
Cervical Dilation ◽  
Non Invasive ◽  
Systolic And Diastolic Function

Abstract BACKGROUND: The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool and can be used to evaluate systolic and diastolic function in fetuses. The objectives of this study were to investigate the MPI during labor and compare it to values in non-laboring women. METHODOLOGY: 40 women with uncomplicated, term, singleton pregnancies were recruited to this prospective observational study at Thomas Jefferson University Hospital. Controls were a retrospective cohort of women > 34 weeks who underwent third trimester fetal echocardiography. Fetal left and right sided isovolumic contraction time, isovolumic relaxation time and ejection time were recorded before, during and after contractions. Right and left sided MPI was then calculated. RESULTS: Laboring patients and non-laboring patients were comparable for age, race, gravidity and parity. During labor the average left MPI was 0.63 ± 0.17 and the average right MPI was 0.62 ± 0.20. The coefficient of correlation between MPI and cervical dilation was 0.15 for left MPI Index and 0.14 for right MPI. When comparing non-laboring to laboring women, the average left MPI for non-laboring women was 0.34 ± 0.04, p = <0.001. CONCLUSIONS: Myocardial Performance Index is a non-invasive, easily attainable measure of cardiac function that can be obtained during labor and does not change with cervical dilation. MPI is significantly different between laboring and non-laboring women. The fetal MPI may help define fetal status in labor.

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