Su Ho-Ming, Lin Tsung-Hsien, Voon Wen-Chol, Lee Kun-Tai, Chu Chih-Sheng, Lai Wen-Ter, Sheu Sheng-Hsiung
Department of Internal Medicine, Division of Cardiology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Echocardiography. 2006 Apr;23(4):287-94. doi: 10.1111/j.1540-8175.2006.00222.x.
Tei index obtained from tissue Doppler echocardiography (TDE-Tei index) has an inherent advantage of recording its systolic and diastolic components simultaneously on the same cardiac cycle. The aims of this study are to evaluate whether TDE-Tei index also exerts a correlation with left ventricular (LV) systolic and diastolic function and filling pressure and to see whether it can effectively identify the pseudonormal/restrictive mitral filling pattern.
Echocardiographic examination was performed in 243 consecutive patients. These patients were classified into three groups as normal, abnormal relaxation, and pseudonormal/restrictive groups according to the transmitral E/A-wave velocity (E/A), early diastolic velocity of lateral mitral annulus (Ea) and E/Ea.
Standard Doppler indices of LV filling such as E, A, E/A, and E-wave deceleration time had a bimodal distribution, but Ea decreased and E/Ea and TDE-Tei index increased progressively with worsening of LV diastolic function. The sensitivity and specificity of TDE-Tei index>0.51 in the discrimination of pseudonormal/restrictive filling pattern were 85% and 96%, respectively. After stepwise multiple linear regression analysis, TDE-Tei index had a significant negative correlation with Ea (beta=-0.296, P<0.001) and ejection fraction (beta=-0.293, P<0.001) and positive correlation with E/Ea (beta=0.235, P=0.001).
TDE-Tei index increased with worsening of LV diastolic function and can effectively identify the pseudonormal/restrictive mitral inflow pattern. It also correlated with the echocardiographic parameters of LV systolic and diastolic function and filling pressure. It suggests that TDE-Tei index is a simple and feasible marker in assessing global LV function.
通过组织多普勒超声心动图获得的Tei指数(TDE-Tei指数)具有在同一心动周期同时记录其收缩期和舒张期成分的固有优势。本研究的目的是评估TDE-Tei指数是否也与左心室(LV)收缩和舒张功能及充盈压相关,并观察其是否能有效识别假性正常/限制性二尖瓣充盈模式。
对243例连续患者进行超声心动图检查。根据二尖瓣E/A波速度(E/A)、二尖瓣环侧壁舒张早期速度(Ea)和E/Ea,将这些患者分为正常、舒张功能异常和假性正常/限制性三组。
左心室充盈的标准多普勒指标,如E、A、E/A和E波减速时间呈双峰分布,但随着左心室舒张功能恶化,Ea降低,E/Ea和TDE-Tei指数逐渐升高。TDE-Tei指数>0.51鉴别假性正常/限制性充盈模式的敏感性和特异性分别为85%和96%。经过逐步多元线性回归分析,TDE-Tei指数与Ea呈显著负相关(β=-0.296,P<0.001),与射血分数呈负相关(β=-0.293,P<0.001),与E/Ea呈正相关(β=0.235,P=0.001)。
TDE-Tei指数随着左心室舒张功能恶化而升高,可有效识别假性正常/限制性二尖瓣血流模式。它还与左心室收缩和舒张功能及充盈压的超声心动图参数相关。这表明TDE-Tei指数是评估左心室整体功能的一个简单可行的指标。