Novel Approach to Measure Myocardial Performance Index: Pulsed‐Wave Tissue Doppler Echocardiography

Abstract

A simple, reproducible, noninvasive myocardial performance index (MPI) for the assessment of overall cardiac function has been described previously. The purpose of this study was to compare the MPI obtained by pulse Doppler method with the MPI obtained by tissue Doppler echocardiography (TDE) in normal subjects and patients with dilated cardiomyopathy (DCMP). Fifteen patients with DCMP and 15 healthy subjects were included. In order to calculate MPI by TDE, isovolumetric contraction (IVCT), relaxation time (IVRT), and ejection time (ET) were measured at two different sites of mitral annulus: septum and lateral. MPI was calculated by dividing the sum of IVCT and IVRT by ET at each site of measurement. The mean MPI value was found by dividing the sum of these MPI values into two. The same parameters were measured using the mitral inflow and left ventricular outflow velocity time intervals in pulsed Doppler method. At all sites measured, MPI by TDE correlated well with conventional MPI both in healthy subjects and patients with DCMP. The highest correlation was observed in mean values of MPI by TDE:r = 0.94, P < 0.0001in healthy subjects; andr = 0.95, P < 0.0001in patients with DCMP. In conclusion, this study clearly demonstrated that MPI could be measured by TDE and it correlated well with conventional MPI in normal and diseased heart.

Effect of cilnidipine on left ventricular function in hypertensive patients as assessed by tissue Doppler Tei index

“…It is reported that the normal value of TDI Tei index range from 0.29-0.36. 11,16,18 The present study illustrates that TDI Tei index is higher in hypertensives, and more prominent in LVH group, but E/A shows no difference between NLVH and LVH groups, which suggests that TDI Tei index is a sensitive parameter for evaluation of global ventricular function before developing ventricular hypertrophy. The present study also supports the opinion that systolic dysfunction coexists with diastolic dysfunction in hypertensives.…”

“…Tei index was reported to be simple, reproducible and independent of HR and blood pressure. 25 Tissue Doppler imaging Tei index was used to evaluate LV function in patients with dilate cardiomyopathy, 16 myocardial infarction 18 and hypertension. 11 In those disease states, Tei index was found to be higher than in normal subjects, and TDI Tei index correlated well with traditional Tei index.…”

“…However, the inability to measure the interval between the end and onset of mitral inflow and the ejection time simultaneously is a limitation of conventional Tei index. 15,16 Tissue Doppler imaging (TDI) is a new ultrasound technique that selectively calculates and displays online myocardial velocity information derived from the Doppler shifts created by cardiac motion. 17 Studies that use Tei index derived from TDI demonstrated that TDI Tei index correlated with conventional Tei index very well.…”

“…17 Studies that use Tei index derived from TDI demonstrated that TDI Tei index correlated with conventional Tei index very well. 16,18 Cilnidipine is a long-acting calcium channel blocker, which blocks not only L-type Ca 2 þ channel in blood vessel but also the N-type Ca 2 þ channel in sympathetic nerve endings. 19,20 Clinical studies demonstrate that cilnidipine is an effective antihypertensive drug.…”

Effects of Rosiglitazone on Cardiac Function in CAPD Patients: A Tissue Doppler Study

“…[27] Thus, TDI-derived MPI serves more reliable global cardiac performance. [27,28] Additionally, E/Em ratio, an important noninvasive marker of LV filling pressure, has been used increasingly in recent years. [29] It was reported that ROS in CAPD patients without diabetes affected glucose metabolism positively and decreased insulin resistance.…”