Kuwahara Eiji, Otsuji Yutaka, Takasaki Kunitsugu, Yuasa Toshinori, Kumanohoso Toshiro, Nakashima Hitoshi, Toyonaga Koichi, Yoshifuku Shiro, Miyata Masaaki, Hamasaki Shuichi, Lee Souki, Kisanuki Akira, Minagoe Shinichi, Tei Chuwa
Department of Cardiovascular Medicine, Kagoshima University School of Medicine, Japan.
Circ J. 2006 Mar;70(3):248-53. doi: 10.1253/circj.70.248.
The estimation of coronary reperfusion in acute myocardial infarction (AMI) is important. The left ventricular (LV) Tei index is a noninvasive and sensitive parameter expressing overall LV function. We hypothesized that patients without good coronary reperfusion have worse LV function with a higher or worse Tei index compared to those with good reperfusion.
In 85 patients with first anteroseptal AMI, without other cardiac lesions such as prior myocardial infarction, LV hypertrophy or valvular disease, the Tei index was measured using Doppler echocardiography immediately after patients' arrival to the hospital, and the Thrombolysis in Myocardial Infarction (TIMI) grade was evaluated through subsequent coronary angiography. The Tei index was significantly greater in patients who did not have TIMI score of 3 compared to those with a TIMI of 3 (0.60+/-0.13 vs 0.46+/-0.06, p<0.0001). A Tei index >0.50 as the criteria for the absence of TIMI 3 had the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 75, 86, 94, 54 and 78%, respectively.
An increased Tei index suggests the absence of adequate coronary reperfusion in patients with first anterior AMI without other lesion.
急性心肌梗死（AMI）中冠状动脉再灌注的评估很重要。左心室（LV）Tei指数是表达左心室整体功能的一种非侵入性且敏感的参数。我们假设与冠状动脉再灌注良好的患者相比，冠状动脉再灌注不佳的患者左心室功能更差，Tei指数更高或更差。
在85例首次发生前间隔AMI且无其他心脏病变（如既往心肌梗死、左心室肥厚或瓣膜病）的患者中，患者入院后立即使用多普勒超声心动图测量Tei指数，并通过随后的冠状动脉造影评估心肌梗死溶栓（TIMI）分级。与TIMI分级为3级的患者相比，TIMI分级未达到3级的患者Tei指数显著更高（0.60±0.13对0.46±0.06，p<0.0001）。以Tei指数>0.50作为TIMI 3级未达到的标准，其敏感性、特异性、阳性预测值、阴性预测值和准确性分别为75%、86%、94%、54%和78%。
Tei指数升高提示无其他病变的首次前壁AMI患者冠状动脉再灌注不足。
