Mukherjee Chirojit, Groeger Steffen, Hogan Maurice, Scholz Markus, Kaisers Udo X, Ender Joerg
Department of Anaesthesiology and Intensive Care Medicine II, Heartcentre, University Leipzig, Strümpelstraβe 39, 04289 Leipzig, Germany.
Ann Card Anaesth. 2012 Apr-Jun;15(2):111-7. doi: 10.4103/0971-9784.95073.
Echocardiographic assessment of systolic left ventricular (LV) function in patients with severe mitral regurgitation (MR) undergoing mitral valve (MV) repair can be challenging because the measurement of ejection fraction (EF) or fractional area change (FAC) in pathological states is of questionable value. The aim of our study was to evaluate the usefulness of the pre-operative Tei Index in predicting left ventricular EF or FAC immediately after MV repair. One hundred and thirty patients undergoing MV repair with sinus rhythm pre- and post-operatively were enrolled in this prospective study. Twenty-six patients were excluded due to absence of sinus rhythm post-operatively. Standard transesophageal examination (IE 33, Philips, Netherlands) was performed before and after cardiopulmonary bypass according to the guidelines of the ASE/SCA. FAC was determined in the transgastric midpapillary short-axis view. LV EF was measured in the midesophageal four- and two-chamber view. For calculation of the Tei Index, the deep transgastric and the midesophageal four-chamber view were used. Statistical analysis was performed with SPSS 17.0. values are expressed as mean with standard deviation. LV FAC and EF decreased significantly after MV repair (FAC: 56±12% vs. 50±14%, P<0.001; EF: 58±11 vs. 50±12Έ P<0.001). The Tei Index decreased from 0.66±0.23 before MV repair to 0.41±0.19 afterwards (P<0.001). No relationship between pre-operative Tei Index and post-operative FAC or post-operative EF were found (FAC: r=-0.061, P=0.554; EF: r=-0.29, P=0.771).
Pre-operative Tei Index is not a good predictor for post-operative FAC and EF in patients undergoing MV repair.
对于接受二尖瓣修复术的严重二尖瓣反流（MR）患者，超声心动图评估左心室（LV）收缩功能可能具有挑战性，因为在病理状态下测量射血分数（EF）或面积变化分数（FAC）的价值存在疑问。我们研究的目的是评估术前Tei指数在预测二尖瓣修复术后即刻左心室EF或FAC方面的有用性。本前瞻性研究纳入了130例术前和术后均为窦性心律且接受二尖瓣修复术的患者。26例患者因术后无窦性心律而被排除。根据美国超声心动图学会/美国心血管麻醉医师协会的指南，在体外循环前后进行标准经食管检查（IE 33，飞利浦，荷兰）。在经胃中乳头肌短轴视图中测定FAC。在食管中段四腔心和两腔心视图中测量左心室EF。为计算Tei指数，使用深部经胃和食管中段四腔心视图。使用SPSS 17.0进行统计分析。数值以平均值±标准差表示。二尖瓣修复术后左心室FAC和EF显著降低（FAC：56±12%对50±14%，P<0.001；EF：58±11对50±12，P<0.001）。Tei指数从二尖瓣修复术前的0.66±0.23降至术后的0.41±0.19（P<0.001）。未发现术前Tei指数与术后FAC或术后EF之间存在相关性（FAC：r=-0.061，P=0.554；EF：r=-0.29，P=0.771）。
术前Tei指数不是二尖瓣修复术患者术后FAC和EF的良好预测指标。
