Tei index: The earliest detectable cardiac structural and functional abnormality detectable in Hb Bart's foetal edema

Sonographic Markers of Fetal α‐Thalassemia Major

“…Published articles also demonstrated that the Tei index in fetuses with α‐thalassemia major was significantly higher than that in healthy fetuses during the first half of pregnancy 68 , 69 . In a pilot study, the ductus venosus forward flow velocity in fetuses with α‐thalassemia major between 12 and 13 weeks was significantly increased.…”

Functional assessment of the fetal heart: a review

“…The flow patterns are usually obtained with PW Doppler, but can also be obtained using M‐mode and tissue Doppler imaging (TDI). As it utilizes only time intervals, it is independent of heart rate and ventricular structure 20, 51. Its use in fetal echocardiography was first reported in 1999, when Tsutsumi et al showed that the Tei index can be used in fetuses, and that there is a decrease in the Tei index of both ventricles during gestation, with a transient increase immediately after birth52.…”

“…The application of color Doppler to TDI enables the assessment of strain rate (change in length per unit time), and, by mathematical derivation, myocardial strain (change in length) itself93. These modalities have the advantage of directly measuring myocardial segments, as opposed to chamber‐dimension changes, and thus should reflect myocardial contractility more accurately20, 29, 40. However, they suffer from the same drawbacks as PW‐TDI, namely angle dependency and assessment of individual segments rather than global function.…”

“…The fetal heart also reacts to damage differently from the adult heart, responding with myocyte proliferation in addition to hypertrophy17–19. Perhaps, for these reasons, deterioration in clinical measure of cardiac function may often be the first sign of fetal pathology20. Therefore, the development of sensitive methods of quantifying fetal cardiac function is of extreme importance, with a particular emphasis on the RV, as this is effectively the systemic ventricle of the fetus.…”

Fetal cardiac Doppler indices in fetuses with hemoglobin Bart's disease at 12–14 weeks of gestation

“…Abnormal cardiac function may probably be an early subtle sign of fetal anemia occurring prior to development of hydrops fetalis. Myocardial performance index or Tei index has been reported to be increased in fetuses with anemia in the second or third trimester [4][5][6]. Nevertheless, to date, fetal myocardial performance in response to anemia in early gestation has never been explored.…”