Tei Index Correlates with Tissue Doppler Parameters and Reflects Neurohormonal Activation in Patients with an Abnormal Transmitral Flow Pattern

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 26; no. 9; pp. 1012 - 1018
• Main Authors: Greco, Stefania, Troisi, Federica, Brunetti, Natale Daniele, Di Biase, Matteo
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.10.2009
• Subjects: Aged; brain natriuretic peptide; diastolic dysfunction; Elasticity Imaging Techniques - methods; Female; Humans; Male; Mitral Valve Insufficiency - blood; Mitral Valve Insufficiency - complications; Mitral Valve Insufficiency - diagnostic imaging; Natriuretic Peptide, Brain - blood; Reproducibility of Results; Sensitivity and Specificity; Statistics as Topic; tei index; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/j.1540-8175.2009.00920.x

Background: Tei index (TI) is a Doppler parameter which reflects combined systolic and diastolic function. We aimed to study the relationship between TI, both traditional and tissue Doppler imaging (TDI) echocardiographic parameters and neurohormonal profile in outpatients with diastolic dysfunction expressed by an abnormal transmitral flow pattern. Methods and Results: A total of 67 consecutive outpatients with diastolic dysfunction (abnormal transmitral flow pattern) were studied; all patients underwent clinical evaluation, blood sampling for B‐type natriuretic peptide (BNP) plasma assaying, echocardiography for the determination of left ventricular ejection fraction (LVEF), dP/dt, left atrium (LA) dimensions, longitudinal systolic (S) and diastolic wall velocities (E′and A′), TI measured with Doppler echocardiography, and mitral regurgitation (MR) quantified on a semicontinuous scale. TI values were significantly correlated with BNP levels (r = 0.33; P < 0.01), LVEF (r =−0.56; P < 0.001), dP/dt (r =−0.52; P < 0.01), S (r =−0.45; P < 0.001), E′(r =−0.36; P < 0.01), A′(r =−0.27; P < 0.05), LA volume (r = 0.35; P < 0.01), and MR (P for trend < 0.05). In a multivariate regression analysis, TI was an independent predictor of increased BNP levels (β= 0.32; P < 0.05), even after correction for potential confounders. ROC analysis showed as values of TI >0.59 identified subjects with combined systolic and diastolic dysfunction with a sensitivity of 73.8% and a specificity of 71.4%. Conclusions: In outpatients with diastolic dysfunction, TI, an easy to perform parameter for global ventricular performance assessment, might be useful in identifying subjects with concomitant systolic impairment and neurohormonal activation.