Tissue doppler myocardial performance index in patients with heart failure and its relationship with haemodynamic parameters

Abstract

The myocardial performance index (MPI) reflects both the systolic and diastolic function of the heart, and is easily applied in practice. In this study, we aimed to determine the relationship between MPI and invasive haemodynamic parameters in heart failure patients. A total of 126 patients with heart failure were selected, all of whom were referred for diagnostic cardiac catheterisation, and were divided into two groups. Group I consisted of 59 patients (32 men and 27 women, mean age 61 ± 10; functional capacity New York Heart Association (NYHA) Class I; and left ventricular end-diastolic pressure (LVEDP) <16 mmHg). Group II included 67 patients (34 men and 33 women, mean age 60 ± 9; NYHA Class ≥ II; LVEDP ≥ 16 mmHg). The following parameters were measured in all patients: ejection fraction with Simpson method, the peak mitral early (E) and late (A) diastolic velocities, E/A ratio, deceleration time (DT) and tissue Doppler from four different areas of the mitral annulus (septum, lateral, inferior and anterior). In order to measure MPI with two methods (standard Doppler and tissue Doppler), isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured from four areas and mean values of MPI were calculated. There was no difference between the two groups in E/A ratios, DT and IVRT (p > 0.05). Group II patients had longer IVCT and ET, when compared with group I patients (p < 0.05). MPI, measured by both standard pulsed wave Doppler and tissue Doppler methods, was significantly higher in group II patients, when compared with the values obtained from group I patients (Group I: 0.50 ± 0.2 and 0.50 ± 0.14; group II: 0.98 ± 0.3 and 1.2 ± 0.32; p < 0.001). According to receiver operating characteristics curve analysis, the cut-off value for MPI measured by tissue Doppler was 0.74. The sensitivity and specificity of this value were measured as 92.5 and 91.5%, respectively. MPI measured by standard Doppler method was 0.67, and its sensitivity and specificity were 85.1 and 83.1%, respectively. We found a strong relationship between MPI and LVEDP (r = 0.83, p < 0.001; r = 0.96, p < 0.001), especially when measured by tissue Doppler. In addition, we observed a significant relationship between the MPI values measured by tissue Doppler and those measured by standard traditional methods (r = 0.85, p < 0.001). We showed that MPI was reliable for the evaluation of global cardiac functions in patients with heart failure, as measured with both pulsed-wave Doppler and tissue Doppler. We assert that, in order to differentiate between those patients with symptomatic heart failure from the asymptomatic cases, MPI as measured with the tissue Doppler method is an improvement on MPI as measured using traditional methods.

Evaluation of cardiac functions of cirrhotic children using serum brain natriuretic peptide and tissue Doppler imaging

“…The MPI which reflects both the global; systolic and diastolic, function of the heart[ 13 ] was significantly higher in cases than controls denoting global cardiac dysfunction.…”

“…TDI showed no significant difference between compensated and decompensated cirrhotic patients; a finding that was also reported by other investigators. [ 13 14 ]…”

Effects of an Isolated Complete Right Bundle Branch Block on Mechanical Ventricular Function

“…The Tei index, also known as the myocardial performance index, is used to evaluate cardiac function on echocardiography 21 . This parameter has been used as a reliable parameter that is easy to obtain, which shows systolic and diastolic myocardial performance together and becomes more important when it is considered that it is affected by both diastolic and systolic function in a manner directly proportional to the isovolumetric contraction time and isovolumic relaxation time and is inversely proportional to the ejection time 22 . The Tei index is unaffected by age, heart rate, blood pressure, or preload, and it contains both systolic and diastolic components; therefore, it is an ideal indicator of changes in overall ventricular systolic and diastolic function 23 , 24 .…”

Cardiac Imaging in Liver Transplantation Candidates: Current Knowledge and Future Perspectives

“…Myocardial Performance Index (MPI/Tei index) is defined as the ratio of isovolumetric contraction time plus isovolumetric relaxation time to the ejection time and has found to be increased in heart failure patients [47]. It has also been shown to be an early marker of systolic or diastolic dysfunction [48,49] and correlates with disease severity [50] and adverse prognosis [51,52]. TDI-derived Tei index is considered more reliable and reproducible than that calculated using pulse-wave Doppler to assess global cardiac function [50].…”

“…It has also been shown to be an early marker of systolic or diastolic dysfunction [48,49] and correlates with disease severity [50] and adverse prognosis [51,52]. TDI-derived Tei index is considered more reliable and reproducible than that calculated using pulse-wave Doppler to assess global cardiac function [50]. This index has been assessed in few studies with cirrhotic patients and has been demonstrated to be related with cirrhosis severity and brain natriuretic peptide (BNP) levels [53,54].…”