Comparison of myocardial performance index obtained either by conventional echocardiography or tissue Doppler echocardiography in healthy subjects and patients with heart failure

Abstract

This study was planned to investigate the normal reference values of myocardial performance index (MPI) obtained by tissue Doppler echocardiography (TDE) and the agreement between MPI measured by TDE and conventional MPI measured by pulsed-wave Doppler (PWD) in healthy subjects and patients with heart failure (HF). Two hundred and three patients with HF and 190 healthy subjects were enrolled in this study. Isovolumic contraction and relaxation time (ICT and IRT) and ejection time (ET) were measured from mitral inflow and left ventricular (LV) outflow. Tissue Doppler echocardiography recordings were obtained at the septal, lateral, inferior, and anterior of the mitral annulus and same time intervals were measured. Myocardial performance index was calculated. The functional capacity of the patients with HF was determined according to New York Heart Association classification. TDE-MPI values were higher than conventional PWD-MPI values in both groups (53%+/-8% vs 48%+/-11%, P<0.0001 in the healthy subjects; 84%+/-21% vs 72%+/-19%, P<0.0001 in the patients with HF). Moderate agreement was found between PWD-MPI and LV mean TDE-MPI in both groups. In identifying patients with moderately or severely decreased LV ejection fraction, TDE-MPI had higher cutoff values than conventional PWD-MPI, and TDE-MPI had higher specificity, sensitivity, negative predictive value, and diagnostic accuracy. In patients with HF, TDE-MPI had a stronger correlation with LV ejection fraction and functional capacity than did PWD-MPI. TDE-MPI is an alternative to conventional PWD-MPI in assessment of cardiac function. However, the higher MPI cutoff points should be considered when this method is used for the evaluation of cardiac function.

Tissue Doppler Time Intervals Predict the Occurrence of Rehospitalization in Chronic Heart Failure: Data from the Daunia Heart Failure Registry

“…22 In identifying patients with moderately or severely decreased LVEF, MPI had higher specificity, sensitivity, negative predictive value, and diagnostic accuracy. 18 Our data seem therefore to confirm previous results by Vizzardi et al, 23 who demonstrated in outpatients setting as MPI is independently related to the incidence of cardiovascular hospitalizations.…”

Myocardial Performance Index Derived from Preejection Period: A Novel and Feasible Parameter in Evaluation of Cardiac Performance in Patients with Permanent Atrial Fibrillation

“…15 The components used to calculate the MPI by pulsed-wave Doppler method are sometimes ob- Table I. tained sequentially from different heart beats if mitral inflow and LV ejection signals cannot be clearly recorded simultaneously and its application may be limited by heart rate fluctuation. Further prospective studies are needed to address this issue.…”

No Myocardial Vulnerability to Mental Stress in Takotsubo Stress Cardiomyopathy

“…MPI can be derived both from Doppler flow and from TDI measurements [15] where the former is the original version used by Tei et al [16]. Compared to pulsed-wave Doppler used by Tei et al MPI derived from tissue Doppler has been shown to correlate better with LV ejection fraction and functional capacity [17]. Since MPI is an estimate of systolic as well as diastolic ventricular function it has been shown to be a sensitive marker for ventricular function [7].…”