Myocardial global performance index as a predictor of in-hospital cardiac events in patients with first myocardial infarction

Ascione, Luigi; Michele, Mario De; Accadia, Maria; Rumolo, Salvatore; Damiano, Lucia; Andrea, Antonello D’; Guarini, Pasquale; Tuccillo, Bernardino

doi:10.1016/s0894-7317(03)00589-3

Cited by 41 publications

(34 citation statements)

References 20 publications

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“…diastolic dysfunction. 15,16 Measures of diastolic function are thus likely to provide incremental prognostic information in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure Patients

et al. 2005

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Background-Left ventricular function is a principal determinant of cardiovascular risk in patients with heart failure. The growing number of patients with preserved systolic function heart failure underscores the importance of understanding the relationship between ejection fraction and risk. Methods and Results-We studied 7599 patients with a broad spectrum of symptomatic heart failure enrolled in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Program. All patients were randomized to candesartan at a target dose of 32 mg once daily or matching placebo and followed up for a median of 38 months. We related left ventricular ejection fraction (LVEF), measured before randomization at the sites, to cardiovascular outcomes and causes of death. Mean LVEF in patients enrolled in CHARM was 38.8Ϯ14.9% (median LVEF 36%). Patients with lower LVEF tended to have higher baseline New York Heart Association class. The hazard ratio for all-cause mortality increased by 39% for every 10% reduction in ejection fraction below 45% (hazard ratio 1.39, 95% CI 1.32 to 1.46), with adjustment for baseline covariates. All-cause mortality, cardiovascular death, and all components of cardiovascular death declined with increasing ejection fraction until an ejection fraction of 45%, after which the risk of these outcomes remained relatively stable with increasing LVEF. The absolute change in rate per 100 patient-years for each 10% reduction in LVEF was greatest for sudden death and heart failure-related death. The effect of candesartan in reducing cardiovascular outcomes was consistent across LVEF categories. Conclusions-LVEF is a powerful predictor of cardiovascular outcome in heart failure patients across a broad spectrum of ventricular function. Nevertheless, once elevated to a range above 45%, ejection fraction does not further contribute to assessment of cardiovascular risk in heart failure patients. (Circulation. 2005;112:3738-3744.)

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“…diastolic dysfunction. 15,16 Measures of diastolic function are thus likely to provide incremental prognostic information in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure Patients

et al. 2005

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“…The conclusion of the study was that the myocardial performance index is a predictor of LV dilatation and cardiac death after AMI. In the present study there was no significant difference between sex and risk factors (diabetes mellitus, hypertension, smoking, and hyperlipidemia) regarding Tei index in hospital and after 3 months [P>0.05] as well as there was no significant difference between patients with and without complications as regard sex and risk factors [P>0.05] while there was significant difference as regard age [P<0.01], where patients with complications were significantly older and Tei index was significantly higher and this was in accordance to Ascione et al, 2003 where patients with acute MI of complicated course were significantly older with no significant difference regarding sex and risk factors.…”

Section: Discussionmentioning

confidence: 61%

“…Also Tei index was significantly higher in complicated than non complicated patients after three months (p 0.001). Thus the Tei index was useful as a predictor of outcome after AMI as this is accordance to [8]. Ascione et al [8] who studied the ability of a doppler index of global myocardial performance (Tei index) measured at entry, to predict in-hospital cardiac events in aseries of patients with first acute MI.…”

Section: Discussionmentioning

confidence: 69%

“…Thus the Tei index was useful as a predictor of outcome after AMI as this is accordance to [8]. Ascione et al [8] who studied the ability of a doppler index of global myocardial performance (Tei index) measured at entry, to predict in-hospital cardiac events in aseries of patients with first acute MI. The mean value of the myocardial performance index (Tei index) was significantly higher in patients with cardiac events than in those without events (p 0.001) so myocardial performance index measured at entry may be useful to predict which patients are at high risk for in hospital cardiac events.…”

Section: Discussionmentioning

confidence: 69%

“…Tei index was found to be the strongest independent predictor of the development of in-hospital congestive heart failure in a small group of patients with acute myocardial infarction [7]. It has been suggested that in the acute phase of myocardial infarction, the myocardial performance index measured at entry may be useful to predict which patients are at high risk for in hospital cardiac events [8].…”

Section: Introductionmentioning

confidence: 99%

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Myocardial Performance Index as a Predictor of IN-Hospital and Short Term Outcome after First Acute Myocardial Infarction

2016

JCCR

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Introduction: Acute myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. It affects both systolic and diastolic functions. The Doppler index of combined systolic and diastolic function (Tei index) was found to be able to separate patients with normal ventricular function from patients with ventricular dysfunction. (Tei) index has been reported to correlate better with patients outcome than conventional echocardiographic parameters in different myocardial diseases. Objectives:The aim of this study is to assess the value of the left ventricular myocardial performance index (MPI) in the prediction of in hospital and short term outcome after first acute myocardial infarction. Material and Methods:Sixty patients admitted to the coronary care unit with first attack of acute myocardial infarction and sixty healthy age and sex comparable group were included. Doppler waves from inverted simultaneous display of the mitral inflow and left ventricular outflow was recorded. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection Time (ET) were measured and then MPI was calculated using the formula (MPI2=IVCT+IVRT/ET).Results: Doppler derived MPI was significantly higher in myocardial infarction patients complicated by heart failure, arrhythmias, post myocardial infarction angina and cardiac death. MPI was inversely correlated with Ejection fraction and positively correlated with EDD and ESD. Conclusion:Myocardial performance index predicts in-hospital and short term outcomes after first acute myocardial infarction.

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Usefulness of Tissue Doppler Imaging‐Myocardial Performance Index in the Evaluation of Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction

Kim

Yoon

Park

et al. 2011

Clinical Cardiology

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Background: In heart failure with preserved ejection fraction (HFPEF), physiological abnormalities are not solely restricted to diastolic function. Because the tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) offers the advantage of recording systolic and diastolic tissue velocity simultaneously in the same cardiac cycle, this study aimed to determine whether TDI-MPI is an informative index for assessing HFPEF, compared with conventional echo parameters. Hypothesis: In patients with HFPEF, TDI-MPI would be an independent predictor for adverse cardiac events. Methods: Among 408 patients who had diastolic dysfunction without heart failure (HF) or HFPEF, cardiac function was evaluated by mitral flow (MF) or TDI-MPI. During the median follow-up of 32 months, clinical outcomes, which were defined as the composite of cardiovascular death and admission for HF, were assessed. Results: Mean MF and TDI-MPI were significantly greater in the HFPEF group. TDI-MPI rather than MF had a significant correlation with N-terminal pro-brain natriuretic peptide level. The area under the receiver operating characteristic curve of TDI-MPI for the detection of HFPEF was 0.86. With regard to clinical outcomes, 31 events were identified during follow-up periods. On a multivariate analysis, TDI-MPI >0.66 was the best prognostic predictor of events and provided incremental predictive value. Conclusions: Compared to MF-MPI, TDI-MPI may be a more useful parameter for the evaluation of patients with HFPEF.

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Myocardial global performance index as a predictor of in-hospital cardiac events in patients with first myocardial infarction

Cited by 41 publications

References 20 publications

Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure Patients

Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure Patients

Myocardial Performance Index as a Predictor of IN-Hospital and Short Term Outcome after First Acute Myocardial Infarction

Usefulness of Tissue Doppler Imaging‐Myocardial Performance Index in the Evaluation of Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction

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