Mansour Hazem, Nassar Ahmed Ibrahim, Abdel Rehim Walaa Adel, Roushdy Alaa Mahmoud, Abobakr Mohamed, Zaki Hala Mohamed, Aboubakr El Missiri Ahmed Mohamed
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Internal Medicine, National Research Center, Cairo, Egypt.
J Cardiovasc Echogr. 2021 Jan-Mar;31(1):11-16. doi: 10.4103/jcecho.jcecho_73_20. Epub 2021 May 21.
Some patients who had chronic coronary syndrome (CCS) and were recognized as low risk, however, developed cardiovascular events, whereas others who were categorized as high risk did not develop any cardiovascular events. Invasive coronary angiography is the gold standard tool for the assessment of coronary artery disease (CAD) severity. The SYNTAX score (SS) was recently recognized as an invasive angiographic-guided scoring system used in risk stratification of patients who have more than one-vessel CAD and undergoing revascularization with percutaneous cardiovascular intervention. It has a good predictive value of adverse cardiovascular events. Exploration for unique noninvasive modalities that may help in a better way for risk stratification of CCS patients by predicting the severity of CAD (as reflected by SS) would be of a paramount value. Tei index is a promising modality for that objective, which is a Doppler-derived time interval index that combines both systolic and diastolic cardiac performance.
We examined the relationship between the severity of CAD as assessed by the SS and Tei index in 100 patients with CCS and normal left ventricular systolic function.
All the studied 100 patients had a normal ejection fraction with mean = 58.92 ± 7.88; the mean value of Tei index was 0.84 ± 0.26. There was a statistically significant positive association between Tei index and SS ( = 0.0001); moreover, there was a correlation between left anterior descending (LAD) affection and Tei index ( = 0.0001).The cutoff point of Tei index to detect SS above 22 was >0.93 (with specificity of 86.5% and sensitivity of 42.4%).
Tei index significantly correlates with SS and LAD affection. Moreover, it is a cheap, radiation-free, noninvasive technique and may be used as a further risk stratification modality beyond others.
一些被认定为低风险的慢性冠状动脉综合征（CCS）患者却发生了心血管事件，而另一些被归类为高风险的患者却未发生任何心血管事件。有创冠状动脉造影是评估冠状动脉疾病（CAD）严重程度的金标准工具。SYNTAX评分（SS）最近被公认为是一种有创血管造影引导的评分系统，用于对多支血管CAD且接受经皮心血管介入血运重建的患者进行风险分层。它对不良心血管事件具有良好的预测价值。探索独特的非侵入性方法，通过预测CAD严重程度（如SS所反映），可能有助于更好地对CCS患者进行风险分层，这将具有至关重要的价值。Tei指数是实现该目标的一种有前景的方法，它是一种通过多普勒得出的时间间隔指数，综合了心脏收缩和舒张功能。
我们在100例左心室收缩功能正常的CCS患者中，研究了由SS评估的CAD严重程度与Tei指数之间的关系。
所有100例研究对象的射血分数均正常，平均值为58.92±7.88；Tei指数的平均值为0.84±0.26。Tei指数与SS之间存在统计学上显著的正相关（=0.0001）；此外，左前降支（LAD）病变与Tei指数之间存在相关性（=0.0001）。检测SS高于22时Tei指数的截断点>0.93（特异性为86.5%，敏感性为42.4%）。
Tei指数与SS及LAD病变显著相关。此外，它是一种廉价、无辐射的非侵入性技术，可作为一种超越其他方法的进一步风险分层手段。
