Prognostic value of the Tei index combining systolic and diastolic myocardial performance in patients with acute myocardial infarction treated by successful primary angioplasty

Abstract

Cardiac systolic (left ventricular ejection fraction) and diastolic (mitral inflow velocity pattern and/or mitral deceleration time) function were reported as predictors of clinical outcome or left ventricular remodeling in patients with acute myocardial infarction (AMI). Recently, a new index (Doppler-derived index combining systolic and diastolic myocardial performance; Tei index) for combined systolic and diastolic ventricular function has been reported to be a useful and convenient method for evaluation of global ventricular function. We therefore investigated the usefulness of the Tei index by echocardiography for evaluation of infarct size and clinical outcome in patients with AMI treated by successful primary angioplasty. We analyzed 10 age-matched control subjects and 43 consecutive patients with first AMI treated by successful primary angioplasty. The Tei index of the AMI patients was significantly greater than that of the control subjects (0.630 +/- 0.106 vs 0.375 +/- 0.036, P << 0.0001). Also, the Tei index showed a significant positive correlation with peak creatine kinase values and (99m)Tc-tetrofosmin scores. Moreover, multiple logistic regression analysis showed that the Tei index >>0.70 ( P = 0.0313, odds ratio = 14.14) was the only significant explanatory factor for cardiac death or developed congestive heart failure. The Tei index combining systolic and diastolic myocardial performance reflects infarct size and might be a predictor of clinical outcome in patients with AMI treated by successful primary angioplasty.

Evaluation of Left Ventricular Tei Index (Index of Myocardial Performance) in Healthy Dogs and Dogs with Mitral Regurgitation

“…The Tei index is a simple and reproducible technique and relatively independent of heart rate (HR) [2,22,26,27], age [7,9], and systemic blood pressure [2,26,27]. Moreover, the index has been demonstrated to be clinically available to estimate the prognosis in human patients with dilated cardiomyopathy (DCM) [5], cardiac amyoloidosis [26], myocardial infraction [23], and primary pulmonary hypertension [25,31]. In addition, a few reports have described the application of the Tei index to human patients with MR due to mitral valvular myxomatous degeneration [1,14].…”

Evaluation of Right Ventricular Tei Index (Index of Myocardial Performance) in Healthy Dogs and Dogs with Tricuspid Regurgitation

“…The Tei index is a simple and reproducible technique, and is relatively independent of heart rate [4,39] and age [19]. In addition, the Tei index has been demonstrated to be clinically useful in estimating the prognosis in human patients with primary PH [37,44], DCM [9], cardiac amyloidosis [38], and myocardial infarction [32]. It could be used for evaluating the RV function as well as the left ventricular function that is unrelated to the complex RV geometric structure [10, 11, 19, 24, 33-35, 37, 44].…”

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

“…The MPI has been considered a good predictor for adverse results in several cardiac diseases, such as valvar insufficiency [13][14][15] , miocardiopathies 16 , acute myocardial infarction 10,17,18,[20][21][22] and cardiac toxicity to anthracycline 23 , with no reference in literature of MPI as a predictor for events in the immediate post-operative period after myocardial revascularization surgery in individuals with previous adequate systolic function.…”

“…This index can be easily obtained and reproduced, regardless of the ventricular geometry, which makes it adequate for the assessment of the overall ventricular function in several clinical situations 10,11 . The index is defined as the sum of the isovolumetric contraction time and isovolumetric relaxing time divided by the ejection time through the Doppler analysis at the mitral inflow and the left ventricular outflow velocity and time [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] …”

“…This index can be easily obtained and reproduced, regardless of the ventricular geometry, which makes it adequate for the assessment of the overall ventricular function in several clinical situations 10,11 . The index is defined as the sum of the isovolumetric contraction time and isovolumetric relaxing time divided by the ejection time through the Doppler analysis at the mitral inflow and the left ventricular outflow velocity and time [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , being considered a possible assessment factor for total cardiac function and cardiac prognosis predictor 10,12,13 . Several studies have evaluated MPI in patients with acute myocardial infarction, miocardiopathy, and valvar disease among others, and the index presented an elevated prediction power for the development of unfavorable outcomes 10,[13][14][15][16][17][18]26 .…”