Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?

Background: Myocardial infarction (MI) results in impairment of left ventricular (LV) systolic and diastolic functions to various degrees. The tissue Doppler image derived Tei index (TDI-Tei index) has recently been used to assess LV function, and like the conventional Tei index, it was also found t...

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Main Author: Eid M. Daoud
Format: Article
Language:English
Published: SpringerOpen 2011-03-01
Series:The Egyptian Heart Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110260811000032
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author Eid M. Daoud
author_facet Eid M. Daoud
author_sort Eid M. Daoud
collection DOAJ
description Background: Myocardial infarction (MI) results in impairment of left ventricular (LV) systolic and diastolic functions to various degrees. The tissue Doppler image derived Tei index (TDI-Tei index) has recently been used to assess LV function, and like the conventional Tei index, it was also found to be useful for global function. There are a small number of studies which apply TDI-Tei index to assess regional function and whether it varies according to the degree of changes in wall motion in various LV segments. Objectives: This study was conducted to assess the changes of segmental myocardial Tei index by TDI according to the degree of changes of wall motion in the patient with acute ST-segment elevation myocardial infarction (STEMI) and its correlation with Tei index derived by conventional Doppler. Patients and methods: This study was carried out on thirty patients with acute STEMI selected from Coronary Care Unit, Cardiology Department, Mansoura Specialized Hospital, Mansoura University, Egypt. The study group was subjected to clinical assessment, electrocardiography (ECG), routine laboratory profile and Doppler echocardiography (conventional and pulsed wave tissue Doppler imaging “PW-TDI”). Tei index was calculated from the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT), divided by ejection time (ET) which were measured from pulsed wave Doppler imaging of the trans-mitral inflow and LV outflow tracts. Myocardial velocities and TDI-Tei index were measured at basal and mid-segments of LV walts from apical 4, 2 and 5-chamber views using 16-segment model. Average values of myocardial velocities and TDI-Tei indices were obtained from normal, hypokinetic and akinetic segments then compared. Results: The mean values of left ventricular ejection fraction (LVEF), mitral E/A ratio and conventional Tei index were 51.83 ± 5.15%, 1.18 ± 0.15 and 0.63 ± 0.07 ms, respectively. Segmental myocardial TDI-Tei index was correlated positively with conventional Tei index (r = 0.648, P < 0.001). TDI-Tei indices were significantly higher in akinetic and hypokinetic segments than those of normal segments (0.70 ± 0.09, 0.64 ± 0.05 vs 0.63 ± 0.05, P < 0.001). Conclusions: Tei index (either conventional or TDI) is superior to EF in evaluation of LV performance in patients with acute STEMI. Tei index derived by myocardial segments by TDI is correlated with conventional Tei index. Segmental TDI-Tei index values differ according to the grade of dysfunctional wall motion.
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spelling doaj.art-427caade32504f79a38d552a47281fc42022-12-21T23:07:35ZengSpringerOpenThe Egyptian Heart Journal1110-26082011-03-016311610.1016/j.ehj.2011.08.002Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?Eid M. DaoudBackground: Myocardial infarction (MI) results in impairment of left ventricular (LV) systolic and diastolic functions to various degrees. The tissue Doppler image derived Tei index (TDI-Tei index) has recently been used to assess LV function, and like the conventional Tei index, it was also found to be useful for global function. There are a small number of studies which apply TDI-Tei index to assess regional function and whether it varies according to the degree of changes in wall motion in various LV segments. Objectives: This study was conducted to assess the changes of segmental myocardial Tei index by TDI according to the degree of changes of wall motion in the patient with acute ST-segment elevation myocardial infarction (STEMI) and its correlation with Tei index derived by conventional Doppler. Patients and methods: This study was carried out on thirty patients with acute STEMI selected from Coronary Care Unit, Cardiology Department, Mansoura Specialized Hospital, Mansoura University, Egypt. The study group was subjected to clinical assessment, electrocardiography (ECG), routine laboratory profile and Doppler echocardiography (conventional and pulsed wave tissue Doppler imaging “PW-TDI”). Tei index was calculated from the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT), divided by ejection time (ET) which were measured from pulsed wave Doppler imaging of the trans-mitral inflow and LV outflow tracts. Myocardial velocities and TDI-Tei index were measured at basal and mid-segments of LV walts from apical 4, 2 and 5-chamber views using 16-segment model. Average values of myocardial velocities and TDI-Tei indices were obtained from normal, hypokinetic and akinetic segments then compared. Results: The mean values of left ventricular ejection fraction (LVEF), mitral E/A ratio and conventional Tei index were 51.83 ± 5.15%, 1.18 ± 0.15 and 0.63 ± 0.07 ms, respectively. Segmental myocardial TDI-Tei index was correlated positively with conventional Tei index (r = 0.648, P < 0.001). TDI-Tei indices were significantly higher in akinetic and hypokinetic segments than those of normal segments (0.70 ± 0.09, 0.64 ± 0.05 vs 0.63 ± 0.05, P < 0.001). Conclusions: Tei index (either conventional or TDI) is superior to EF in evaluation of LV performance in patients with acute STEMI. Tei index derived by myocardial segments by TDI is correlated with conventional Tei index. Segmental TDI-Tei index values differ according to the grade of dysfunctional wall motion.http://www.sciencedirect.com/science/article/pii/S1110260811000032Tei indexMyocardial infarctionTissue Doppler imaging
spellingShingle Eid M. Daoud
Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
The Egyptian Heart Journal
Tei index
Myocardial infarction
Tissue Doppler imaging
title Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
title_full Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
title_fullStr Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
title_full_unstemmed Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
title_short Conventional and segmental myocardial Tei indices measurement in patients with acute ST-segment elevation myocardial infarction: Is there a relation?
title_sort conventional and segmental myocardial tei indices measurement in patients with acute st segment elevation myocardial infarction is there a relation
topic Tei index
Myocardial infarction
Tissue Doppler imaging
url http://www.sciencedirect.com/science/article/pii/S1110260811000032
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