Hole Torstein, Vegsundvåg Johnny, Skjaerpe Terje
Section of Cardiology, Medical Department, Alesund Hospital, Norway.
Echocardiography. 2003 Apr;20(3):231-6. doi: 10.1046/j.1540-8175.2003.03020.x.
The aim of the study was to validate a previously published method to calculate left ventricular ejection fraction (EF) from the myocardial performance index (MPI or Tei-index) in patients with acute myocardial infarction (MI).
Sixty-one patients in sinus rhythm without overt heart failure were examined between 2 and 7 days after the acute MI. Doppler tracings from mitral inflow and left ventricular outflow were recorded together with two-dimensional echocardiographic (2DE) recordings. MPI was calculated from the Doppler tracings, and EF measured with the biplane Simpson's method. From MPI the EF was calculated by the formula EF = 0.60 - (0.34 x MPI). Radionuclide angiographic (RNA) measurements of EF were performed within 1 day of the Doppler echocardiography.
Compared with radionuclide EF, MPI derived EF significantly underestimated EF by 0.03 (+/-0.013; P = 0.027), whereas there was no significant difference in mean EF between 2DE and RNA. There was no statistically significant difference in the agreement between MPI derived EF relative to RNA, or 2DE relative to RNA. The agreement between the three methods was only moderate with wide limits of agreement (+/-0.17). The relationship expressed by the proposed formula for calculating EF from MPI was not statistically significant in regression analysis in this patient population.
No statistically significant relationship was found between MPI and EF by radionuclide angiography. However, MPI derived EF was as accurate as biplane echocardiographic measurements of EF when compared with radionuclide EF, but the agreement between methods was only moderate.
本研究旨在验证一种先前发表的方法，该方法可根据急性心肌梗死（MI）患者的心肌性能指数（MPI或Tei指数）计算左心室射血分数（EF）。
对61例窦性心律且无明显心力衰竭的患者在急性心肌梗死后2至7天进行检查。记录二尖瓣血流和左心室流出道的多普勒描记图以及二维超声心动图（2DE）记录。根据多普勒描记图计算MPI，并采用双平面辛普森法测量EF。根据MPI，通过公式EF = 0.60 - (0.34 x MPI)计算EF。在多普勒超声心动图检查后1天内进行放射性核素血管造影（RNA）测量EF。
与放射性核素EF相比，MPI衍生的EF显著低估EF 0.03（±0.013；P = 0.027），而2DE和RNA之间的平均EF无显著差异。MPI衍生的EF相对于RNA，或2DE相对于RNA的一致性无统计学显著差异。三种方法之间的一致性仅为中等，一致性界限较宽（±0.17）。在该患者群体的回归分析中，从MPI计算EF的建议公式所表达的关系无统计学显著意义。
放射性核素血管造影显示MPI与EF之间未发现统计学显著关系。然而，与放射性核素EF相比，MPI衍生的EF与双平面超声心动图测量EF一样准确，但方法之间的一致性仅为中等。
