Yuasa Toshinori, Otsuji Yutaka, Kuwahara Eiji, Takasaki Kunitsugu, Yoshifuku Shiro, Yuge Keiko, Kisanuki Akira, Toyonaga Kouichi, Lee Souki, Toda Hitoshi, Kumanohoso Toshiro, Hamasaki Shuichi, Matsuoka Tatsuru, Biro Sadatoshi, Minagoe Shinichi, Tei Chuwa
Department of Cardiovascular, Repiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima City 890-8520, Japan.
J Am Soc Echocardiogr. 2005 Jan;18(1):20-5. doi: 10.1016/j.echo.2004.08.034.
Tei index has been proposed as a noninvasive and simple index that enables the evaluation of global left ventricular (LV) function and prediction of patient prognosis. However, its use to predict complications with acute myocardial infarction (AMI) is not fully investigated. Therefore, the purpose of this study was to investigate whether or not LV Tei index allows noninvasive prediction of complications with AMI.
In all, 80 consecutive patients with anteroseptal AMI were enrolled. LV Tei index was measured at the time of admission as (a - b)/ b , where a is the interval between cessation and onset of mitral filling flow and interval b is the aortic flow ejection time. Subsequent complications including cardiac death, shock, congestive heart failure, ventricular tachycardia/fibrillation, paroxysmal atrial fibrillation/flutter, advanced atrioventricular block requiring pacing, pericardial effusion, and LV aneurysm during the 30 days after the onset of AMI were prospectively evaluated and compared with the initial Tei index at admission.
Complications developed in 31 of 80 (39%) patients with AMI. The Tei index was significantly increased for patients with complications compared with those without them (0.69 +/- 0.16 vs 0.50 +/- 0.11, P < .0001). When Tei index > or = 0.59 was used for the criteria, the sensitivity, specificity, and overall accuracy to predict subsequent complications were 77%, 86%, and 85%, respectively.
In patients with anteroseptal AMI, LV Tei index at arrival to the hospital in the acute phase allows noninvasive prediction of subsequent complications.
Tei指数已被提出作为一种无创且简单的指数，可用于评估左心室整体功能并预测患者预后。然而，其用于预测急性心肌梗死（AMI）并发症的情况尚未得到充分研究。因此，本研究的目的是探讨左心室Tei指数是否能够无创预测AMI并发症。
总共纳入了80例连续的前间隔AMI患者。入院时测量左心室Tei指数，计算公式为（a - b）/ b，其中a为二尖瓣充盈血流停止与开始之间的间隔时间，b为主动脉血流射血时间。前瞻性评估AMI发病后30天内的后续并发症，包括心源性死亡、休克、充血性心力衰竭、室性心动过速/颤动、阵发性心房颤动/扑动、需要起搏的高度房室传导阻滞、心包积液和左心室室壁瘤，并与入院时最初的Tei指数进行比较。
80例AMI患者中有31例（39%）发生了并发症。发生并发症的患者的Tei指数显著高于未发生并发症的患者（0.69±0.16对0.50±0.11，P <.0001）。以Tei指数≥0.59为标准时，预测后续并发症的敏感性、特异性和总体准确性分别为77%、86%和85%。
在前间隔AMI患者中，急性期入院时的左心室Tei指数能够无创预测后续并发症。
