Zhang Yicen, Sun Guotong, Zhu Wenyuan, Wang Peixin, Wang Lei, Dai Hongyan
Department of Cardiology, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, 266071, China.
Department of Cardiology, Shouguang Hospital of T.C.M, Weifang, 262700, China.
Heliyon. 2023 Oct 5;9(10):e20666. doi: 10.1016/j.heliyon.2023.e20666. eCollection 2023 Oct.
Doppler-derived myocardial performance index (Tei) has been used in the evaluation of right ventricular (RV) function. However, the usage in isolated diastolic dysfunction is limited.We sought to find a new Tei'-index that is more appropriate for evaluating isolated diastolic dysfunction (IDD) based on the symmetry of cardiac structure and function.
21 patients with impaired RV relaxation were compared to 44 control subjects. Tei and Tei' including their components, isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), the ejection time (ET), and RV rapid filling time (RFT) were measured from RV outflow and tricuspid inflow Doppler velocity profiles.
Tei-index have no change between IDD group and control subjects (0.21 ± 0.08 vs 0.23 ± 0.07 P[bond, double bond]NS). The Tei'-index was significantly shortened in IDD group(0.24 ± 0.09 vs 0.32 ± 0.12,p<0.05).The decrease in Tei'-index was due to the prolongation of both IRT and RFT, and in the abbreviation of ICT. Tei'-index cutoff value of ≥0.31 identified impaired RV relaxation with a sensitivity of 50 % and specificity of 86 %.We also find that the Tei'-index correlated well with doppler measures of diastolic parameters like E/A, E/e', DT, which suggests its potential use as a noninvasive indicator of the right ventricular (RV) relaxation in patients with heart failure of different causes.
New Tei's index is highly effective and specific in the evaluation of early diastolic dysfunction of right ventricle, and can be used as an indicator for the detection of IDD in clinic.
多普勒衍生心肌性能指数(Tei指数)已用于评估右心室(RV)功能。然而,其在单纯舒张功能障碍中的应用有限。我们试图基于心脏结构和功能的对称性找到一种更适合评估单纯舒张功能障碍(IDD)的新Tei'指数。
将21例右心室舒张功能受损患者与44例对照者进行比较。从右心室流出道和三尖瓣流入道多普勒速度曲线测量Tei指数和Tei'指数及其组成部分,等容舒张时间(IRT)、等容收缩时间(ICT)、射血时间(ET)和右心室快速充盈时间(RFT)。
Tei指数在IDD组和对照组之间无变化(0.21±0.08 vs 0.23±0.07,P>0.05)。Tei'指数在IDD组显著缩短(0.24±0.09 vs 0.32±0.12,p<0.05)。Tei'指数的降低是由于IRT和RFT均延长,以及ICT缩短。Tei'指数截断值≥0.31时识别右心室舒张功能受损的敏感性为50%,特异性为86%。我们还发现Tei'指数与舒张参数如E/A、E/e'、DT的多普勒测量值相关性良好,这表明其有可能作为不同病因心力衰竭患者右心室舒张功能的无创指标。
新的Tei'指数在评估右心室舒张早期功能障碍方面具有高效性和特异性,可作为临床检测IDD的指标。