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- Title
Improvement of Myocardial Performance (Tei) Index Closely Reflects Intrinsic Improvement of Cardiac Function: Assessment in Revascularized Hibernating Myocardium.
- Authors
Carluccio, Erberto; Biagioli, Paolo; Alunni, Gianfranco; Murrone, Adriano; Zuchi, Cinzia; Biscottini, Emilia; Lauciello, Rosanna; Pantano, Paola; Gentile, Federico; Nishimura, Rick A; Ambrosio, Giuseppe
- Abstract
Background: Myocardial performance index (MPI), or Tei index, is an indicator of systolic and diastolic myocardial function. MPI increases in case of cardiac dysfunction; however, whether reversal of left ventricular dysfunction is also reflected by concomitant improvement (i.e., decrease) of MPI is unknown. Methods: Fifty-two patients with chronic ischemic cardiomyopathy and viable myocardium by dobutamine stress echocardiography were studied by echocardiography before and more than 4 months after cardiac revascularization. Patients were in optimal medical therapy, which remained unchanged following revascularization. Results: At baseline, ejection fraction (EF: 32 ± 6%) and wall motion score index (WMSI: 2.37 ± 0.32) were impaired, and MPI averaged 0.71 ± 0.19. Revascularization markedly improved EF (44 ± 10%, P < 0.0001) and WMSI (1.77 ± 0.44, P < 0.0001). MPI also improved (0.59 ± 0.26, P < 0.0001), and its decrease was significantly correlated with the improvement in EF (r =−0.68, P < 0.0001) and to the extent of viable myocardium (r =−0.45, P = 0.0007). Responders to revascularization (≥5% increase in EF at follow-up, n = 40% and 77%) achieved a significant improvement in MPI at follow-up in contrast with nonresponders (−23 ± 25% vs. 0.02 ± 0.18%, P = 0.001). Improvement in MPI was largely driven by a significant reduction in isovolumic contraction time (P < 0.001) with consequent prolongation of the ejection phase. Conclusion: In patients with chronic ischemic cardiomyopathy, MPI improves along with recovery of function, reflecting the intrinsic improvement of viable segments induced by revascularization. (Echocardiography, ****;**:1-9)
- Subjects
HEART ventricle diseases; ANGIOPLASTY; BLOOD flow measurement; CHI-squared test; CONVALESCENCE; CORONARY artery bypass; DOBUTAMINE; DOPPLER echocardiography; LEFT heart ventricle; HEMODYNAMICS; MATHEMATICAL statistics; MULTIVARIATE analysis; MYOCARDIAL revascularization; CARDIOMYOPATHIES; NONPARAMETRIC statistics; REGRESSION analysis; RESEARCH evaluation; STATISTICS; T-test (Statistics); U-statistics; DATA analysis; PARAMETERS (Statistics); INTER-observer reliability; DATA analysis software; DESCRIPTIVE statistics
- Publication
Echocardiography, 2012, Vol 29, Issue 3, p298
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2011.01575.x