Sivanandam Shanthi, Wey Andrew, St Louis James
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Ann Card Anaesth. 2015 Apr-Jun;18(2):198-201. doi: 10.4103/0971-9784.154474.
Use of the Tei index has not been described to assess myocardial function before or after surgery in pediatric patients. This study was designed to evaluate the left ventricular (LV) function using the Tei index pre- and post-cardiopulmonary bypass in patients with lesion that result in a volume loaded right ventricle (RV).
Retrospective data on 55 patients who underwent repair of a cardiac defect were analyzed. Patients with volume overload RV (n = 15) were compared to patients without volume overload but with other cardiac defects (n = 40). We reviewed pre- and post-operative LV myocardial performance index (Tei index). Tei index was obtained from transesophageal Doppler echocardiogram.
Patients with right heart volume overload, the mean preoperative Tei index was 0.6, with a postoperative mean decrease of 0.207 (P = 0.014). Patients without right heart volume overload, the mean preoperative Tei was 0.48 with no significant postoperative change (P = 0.82).
Pre- and post-operative transesophageal echocardiogram assessment provides an easy and quick way of evaluating LV function intra-operatively using LV Tei index. Preoperative LV Tei index was greater in the RV volume overload defects indicating diminished LV global function. This normalized in the immediate postoperative period, implying an immediate improvement in LV function. In patients without right heart volume load, consist of other cardiac defects, demonstrated no changes in the pre- and post-operative LV Tei. This implies that LV function was similar after the surgery.
尚未有研究描述使用Tei指数评估小儿患者手术前后的心肌功能。本研究旨在利用Tei指数评估体外循环前后左心室（LV）功能，这些患者因病变导致右心室（RV）容量负荷增加。
分析了55例接受心脏缺陷修复手术患者的回顾性数据。将右心室容量超负荷患者（n = 15）与无容量超负荷但有其他心脏缺陷的患者（n = 40）进行比较。我们回顾了术前和术后左心室心肌性能指数（Tei指数）。Tei指数通过经食管多普勒超声心动图获得。
右心容量超负荷患者术前Tei指数平均为0.6，术后平均下降0.207（P = 0.014）。无右心容量超负荷患者术前Tei平均为0.48，术后无显著变化（P = 0.82）。
术前和术后经食管超声心动图评估提供了一种使用左心室Tei指数在术中评估左心室功能的简便快捷方法。右心室容量超负荷缺陷患者术前左心室Tei指数较高，表明左心室整体功能减弱。术后即刻该指标恢复正常，这意味着左心室功能立即得到改善。在无右心容量负荷、存在其他心脏缺陷的患者中，术前和术后左心室Tei无变化。这表明术后左心室功能相似。
