Segmental Tissue Doppler Image-Derived Tei Index in Patients With Regional Wall Motion Abnormalities

Background and Objectives Although the Tei index is a useful predictor of global ventricular function, it has not been investigated at the level of regional myocardial function. We therefore investigated the segmental tissue Doppler image derived-Tei index (TDI-Tei index) in patients with regional wall motion abnormalities. Subjects and Methods We prospectively studied 17 patients (mean age 62±9 years, 5 women) with left ventricular (LV) regional wall motion abnormalities. The Tei index, defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET), was measured in the basal and mid segments of the LV walls from standard apical views (4-, 2-, and 5-chamber views). We also obtained TDI velocity data in each segment. LV wall motion was classified as normal, hypokinetic, or akinetic, based on visual analysis. The TDI-Tei index, peak systolic myocardial velocity (Sm), early diastolic myocardial velocity (Em), and late diastolic myocardial velocity (Am) were analyzed in a total of 203 segments. Results Mean LV ejection fraction was 41.8±8.5%. TDI-Tei indices of dysfunctional segments (akinesis or hypokinesis, n=63) were significantly higher than those of normal segments (n=140) (0.714±0.169 vs. 0.669±0.135, p=0.041, respectively). Average values of TDI-Tei index, Sm, Em, and Am were 0.742±0.201, 4.206±1.336, 5.258±1.867, and 5.578±2.354 in akinetic segments; 0.677±0.101, 4.908±1.615, 5.369±2.121, and 5.542±2.492 in hypokinetic segments; and 0.669±0.135, 5.409±1.519, 6.108±2.356, and 6.719±2.466 in normal segments, respectively. A significant negative correlation was apparent between the TDI-Tei index and Sm (r=-0.302, p<0.001). Conclusion These data suggest that the value of the segmental TDI-Tei index differs significantly according to regional function grade.

[1]  Ho-Ming Su,et al.  Correlation of Tei Index Obtained from Tissue Doppler Echocardiography with Invasive Measurements of Left Ventricular Performance , 2007, Echocardiography.

[2]  R. Hetzer,et al.  Comparison of the Tissue Doppler-Derived Left Ventricular Tei Index to that Obtained by Pulse Doppler in Patients with Congenital and Acquired Heart Disease , 2005, Pediatric Cardiology.

[3]  Richard B Devereux,et al.  Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardio , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[4]  J B Seward,et al.  Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. , 1998, The American journal of cardiology.

[5]  K. Harada,et al.  Comparison of the right ventricular Tei index by tissue Doppler imaging to that obtained by pulsed Doppler in children without heart disease. , 2002, The American journal of cardiology.

[6]  L. Køber,et al.  Prognostic importance of systolic and diastolic function after acute myocardial infarction. , 2003, American heart journal.

[7]  I. Sohn,et al.  Tissue Doppler Image-Derived Myocardial Performance(Tei Index) as a Simple Assessment of Global Cardiac Function in Adults , 2005 .

[8]  C. Erem,et al.  Assessment of the Tei Index by Tissue Doppler Imaging in Patients with Acromegaly: Serum Growth Hormone Level Is Associated with the Tei Index , 2008, Echocardiography.

[9]  J. Seward,et al.  New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. , 1995, Journal of cardiology.

[10]  I. Uzunhasan,et al.  Correlation of the Tei index with left ventricular dilatation and mortality in patients with acute myocardial infarction. , 2006, International heart journal.

[11]  C. Tei,et al.  New non-invasive index for combined systolic and diastolic ventricular function. , 1995, Journal of cardiology.

[12]  Ho-Ming Su,et al.  Differentiation of Left Ventricular Diastolic Dysfunction, Identification of Pseudonormal/Restrictive Mitral Inflow Pattern and Determination of Left Ventricular Filling Pressure by Tei Index Obtained from Tissue Doppler Echocardiography , 2006, Echocardiography.

[13]  A J Tajik,et al.  Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. , 1996, Journal of the American College of Cardiology.

[14]  H. Sasao,et al.  Prognostic value of the Tei index combining systolic and diastolic myocardial performance in patients with acute myocardial infarction treated by successful primary angioplasty , 2004, Heart and Vessels.

[15]  R Erbel,et al.  Tei-index in patients with mild-to-moderate congestive heart failure. , 2000, European heart journal.