Uzunhasan Isil, Bader Khalid, Okçun Bans, Hatemi Ali Can, Mutlu Hasim
Department of Cardiology, Medical Faculty, Istanbul University, Istanbul, Turkey.
Int Heart J. 2006 May;47(3):331-42. doi: 10.1536/ihj.47.331.
The Tei index is an echocardiographic index of combined systolic and diastolic function, calculated as isovolumetric relaxation time plus isovolumetric contraction time divided by ejection time. The aim of this study was to define the correlation of the Tei index with left ventricular dilatation and mortality in patients with acute myocardial infarction (AMI). A total of 77 patients (58 men, 19 women) with a mean age of 53 +/- 12 years, who had presented with an AMI in our clinic between June 2001 and February 2002 were compared with a control group of 88 healthy subjects (63 men, 25 women) with a mean age of 55 +/- 6 years. Echocardiographic evaluation was carried out within 24 hours and the third month of AMI, using a 3.5 MHz probe with pulse wave Doppler recordings by the adult cardiac mode of an Acuson C 256 echocardiograph. There were statistically significant differences between the 2 groups in all echocardiographic parameters, except mitral A wave. Thirteen patients died during the follow-up period of 3 months. The Tei index was significantly higher in the patients who died compared with those who survived (0.70 +/- 0.10 versus 0.61 +/- 0.10; P < 0.001). The patients who had heart failure after AMI had a mean Tei index value of 0.76 +/- 0.27, whereas the patients who did not have heart failure after AMI had a significantly lower Tei index value of 0.60 +/- 0.32 (P < 0.05). Patients were divided into 2 groups according to their Tei index. Patients with a > 0.60 Tei index had significantly higher end-systolic and end-diastolic volumes compared to patients with a < 0.60 Tei index (P < 0.001 for both) in the acute phase of AMI. Within 3 months, patients with a Tei index < 0.60 had a significant reduction in end-diastolic volumes (P < 0.01), whereas the end-diastolic volumes did not change significantly in patients with an index > 0.60 (P = 0.19). The Tei index is an important indicator of left ventricular dysfunction and death after AMI. A greater Tei index at the onset of AMI is associated with a higher incidence of subsequent cardiac death, CHF, and progressive LV remodeling.
Tei指数是一个反映心脏收缩和舒张功能的超声心动图指标，计算方法为等容舒张时间与等容收缩时间之和除以射血时间。本研究旨在确定急性心肌梗死（AMI）患者中Tei指数与左心室扩张及死亡率之间的相关性。选取2001年6月至2002年2月在我院就诊的77例AMI患者（58例男性，19例女性），平均年龄53±12岁，与88例健康对照者（63例男性，25例女性），平均年龄55±6岁进行比较。在AMI发病24小时内及发病后第三个月进行超声心动图评估，使用Acuson C 256超声心动图仪的成人心脏模式，配备3.5MHz探头及脉冲波多普勒记录。除二尖瓣A波外，两组在所有超声心动图参数上均存在统计学显著差异。在3个月的随访期内，有13例患者死亡。死亡患者的Tei指数显著高于存活患者（0.70±0.10对0.61±0.10；P<0.001）。AMI后发生心力衰竭的患者Tei指数平均值为0.76±0.27，而AMI后未发生心力衰竭的患者Tei指数值显著较低，为0.60±0.32（P<0.05）。根据Tei指数将患者分为两组。在AMI急性期，Tei指数>0.60的患者与Tei指数<0.60的患者相比，其收缩末期和舒张末期容积显著更高（两者P均<0.001）。在3个月内，Tei指数<0.60的患者舒张末期容积显著减小（P<0.01），而Tei指数>0.60的患者舒张末期容积无显著变化（P = 0.19）。Tei指数是AMI后左心室功能障碍和死亡情况的重要指标。AMI发病时Tei指数越高，随后发生心脏死亡、心力衰竭及进行性左心室重构的发生率越高。
