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Clin Cardiol. 2011 Aug;34(8):494-9. doi: 10.1002/clc.20932. Epub 2011 Jul 20.

Usefulness of tissue Doppler imaging-myocardial performance index in the evaluation of diastolic dysfunction and heart failure with preserved ejection fraction.

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1
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea. khyungseop@dsmc.or.kr

Abstract

BACKGROUND:

In heart failure with preserved ejection fraction (HFPEF), physiological abnormalities are not solely restricted to diastolic function. Because the tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) offers the advantage of recording systolic and diastolic tissue velocity simultaneously in the same cardiac cycle, this study aimed to determine whether TDI-MPI is an informative index for assessing HFPEF, compared with conventional echo parameters.

HYPOTHESIS:

In patients with HFPEF, TDI-MPI would be an independent predictor for adverse cardiac events.

METHODS:

Among 408 patients who had diastolic dysfunction without heart failure (HF) or HFPEF, cardiac function was evaluated by mitral flow (MF) or TDI-MPI. During the median follow-up of 32 months, clinical outcomes, which were defined as the composite of cardiovascular death and admission for HF, were assessed.

RESULTS:

Mean MF and TDI-MPI were significantly greater in the HFPEF group. TDI-MPI rather than MF had a significant correlation with N-terminal pro-brain natriuretic peptide level. The area under the receiver operating characteristic curve of TDI-MPI for the detection of HFPEF was 0.86. With regard to clinical outcomes, 31 events were identified during follow-up periods. On a multivariate analysis, TDI-MPI >0.66 was the best prognostic predictor of events and provided incremental predictive value.

CONCLUSIONS:

Compared to MF-MPI, TDI-MPI may be a more useful parameter for the evaluation of patients with HFPEF.

PMID:
21780137
DOI:
10.1002/clc.20932
[Indexed for MEDLINE]
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