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Tei 指数在疑似 Takotsubo 综合征的诊断工作中补充了常规超声心动图参数。

Tei Index Complements Conventional Echocardiographic Parameters in Diagnostic Workup of Suspected Takotsubo Syndrome.

机构信息

Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.

出版信息

Med Princ Pract. 2023;32(1):9-15. doi: 10.1159/000528639. Epub 2022 Dec 26.

Abstract

BACKGROUND

Tei index (TI) is a combined myocardial performance index for overall cardiac function, the sensitivity of which seems to be better than that of systolic and diastolic parameters alone. Evidence for TI in the context of Takotsubo syndrome (TTS) is currently limited, which is why we chose to investigate this parameter in affected patients.

SUBJECTS AND METHODS

Patients with TTS (n = 51), acute coronary syndrome (ACS; n = 29), and controls (n = 58) were retrospectively investigated. Laboratory and echocardiographic parameters including TI were analyzed for their ability to discriminate TTS in the total study cohort.

RESULTS

TI was the highest, and thus most pathological, in patients with TTS (median 0.516 vs. ACS: 0.355 vs. control: 0.313, p < 0.0001) and showed the best discriminatory ability for TTS (AUC: 0.836, p < 0.0001). A cut-off for diagnosis of TTS was calculated at ≥0.418 (specificity: 83.5% and sensitivity: 74.0%) by means of the Youden index.

CONCLUSION

The discriminatory ability of TI was better than that of other echocardiographic parameters such as LV systolic function. Due to the simple, fast, and inexpensive way of calculating TI, diagnostic workup with conventional parameters could be complemented by TI in patients with suspected TTS.

摘要

背景

心肌做功指数(Tei 指数,TI)是一种综合的心肌整体功能的检测指标,其敏感性似乎优于单独的收缩和舒张参数。Takotsubo 综合征(TTS)背景下 TI 的证据目前有限,这就是为什么我们选择在受影响的患者中研究这一参数。

受试者和方法

回顾性调查了 TTS 患者(n=51)、急性冠状动脉综合征(ACS;n=29)和对照组(n=58)。分析了包括 TI 在内的实验室和超声心动图参数,以评估其在整个研究队列中区分 TTS 的能力。

结果

TTS 患者的 TI 最高,因此最具病理意义(中位数 0.516 vs. ACS:0.355 vs. 对照组:0.313,p<0.0001),并且对 TTS 的区分能力最好(AUC:0.836,p<0.0001)。通过约登指数计算出诊断 TTS 的截断值为≥0.418(特异性:83.5%和敏感性:74.0%)。

结论

TI 的区分能力优于其他超声心动图参数,如左心室收缩功能。由于 TI 的计算简单、快速且廉价,因此在疑似 TTS 的患者中,常规参数的诊断检查可以补充 TI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfd8/10267490/9443222b3908/mpp-0032-0009-g01.jpg

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