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Karabacak M, Peynirci A, Ozdil O, Tayyar S, Kuyumcu MS. The Relationship Between Global Left Ventricular Function, as Indicated by the Tei Index, and Long-Term Survival in Patients With Non-Ischemic, Dilated Cardiomyopathy. KARDIOLOGIIA 2023; 63:78-83. [PMID: 37970859 DOI: 10.18087/cardio.2023.10.n2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/28/2022] [Indexed: 11/19/2023]
Abstract
AIM Idiopathic dilated cardiomyopathy (DCM) is one of the leading causes of low ejection fraction (EF) heart failure (HF). The Tei index is a reliable marker that reflects both left ventricular (LV) systolic and diastolic function, and it has prognostic value in patients with DCM. We aimed to investigate the relationship between the Tei index and long-term survival in non-ischemic, DCM patients. MATERIAL AND METHODS The present study included 98 patients with non-ischemic DCM. The mean survival time of the patients was 59 mos. RESULTS The Tei index was prominently higher in patients who died (0.64±0.08 vs 0.71±0.12, respectively; p=0.01). LV end-systolic volume and LV ejection fraction (LVEF) were independent prognostic factors and predicted worse long-term survival. Additionally, the patients with LVEF ≥32.7 % and the Tei index ≤0.76 had significantly longer survival. CONCLUSION The present study showed that the Tei index was significantly associated with mortality and the patients with both low LVEF (≤32.7 %) and high Tei index (≥0.76) values had a shorter life expectancy. As a result, we suggest that the Tei index may be a useful echocardiographic marker to predict long-term survival in DCM patients.
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Affiliation(s)
- M Karabacak
- Suleyman Demirel University, Department of Cardiology, Medical Faculty
| | - A Peynirci
- Suleyman Demirel University, Department of Cardiology, Medical Faculty
| | - O Ozdil
- Suleyman Demirel University, Department of Cardiology, Medical Faculty
| | - Senol Tayyar
- Private Meddem Hospital, Department of Cardiology
| | - M S Kuyumcu
- Suleyman Demirel University, Department of Cardiology, Medical Faculty
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Gicana KRB, Lertwanakarn T, Tachampa K. Novel Approach to Assess Cardiac Function Using Systolic Performance and Myocardial Performance Indices From Simultaneous Electrocardiography and Phonocardiography Recordings in Dogs With Various Stages of Myxomatous Mitral Valve Disease. Front Vet Sci 2021; 8:741115. [PMID: 34746282 PMCID: PMC8566337 DOI: 10.3389/fvets.2021.741115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Myxomatous mitral valve disease (MMVD) progression entails changes in the structural and functional properties of the heart affecting cardiac timings and intervals within the cardiac cycle. Conventionally, echocardiography is used to determine the cardiac time intervals (CTIs) including systolic and myocardial performance indices (SPI and MPI) in evaluating cardiac function. Alternatively, these CTIs can also be measured using simultaneous recordings of electrocardiography (ECG) and phonocardiography (PCG), but their values in different MMVD stages remain to be established. This study aimed to establish and prove the use of derived SPI and MPI from a dedicated device as a novel approach to assess cardiac function in different stages of MMVD dogs. Materials and Methods: A prospective study in 52 dogs with different MMVD stages measured the CTIs using a novel device. These were compared and correlated with standard echocardiographic parameters. The predictive value of SPI and three new proposed formulas to estimate MPI (i.e., F1, F2, and F3) in association with asymptomatic from symptomatic MMVD dogs were investigated. Results: Our findings revealed that CTI parameters measured from a novel device including QS1, QS2, S1S2, MPI-F1, and MPI-F2 were altered at different stages of MMVD. The SPI and all proposed MPI formulas were comparable with the systolic time interval and Tei index from echocardiography. In addition, the SPI, MPI-F1, and MPI-F2 were significantly correlated with the Tei index. However, the SPI was not able to differentiate the various stages of MMVD. Conversely, only the MPI-F1 (i.e., (QS1 + S2)/S1S2) demonstrated good predictive accuracy when compared between asymptomatic and symptomatic MMVD dogs similar to the Tei index. Moreover, this formula was able to differentiate stages B1 and C with remarkable predictive accuracy, higher sensitivity, and high specificity when compared with the Tei index. Conclusion: We have successfully described the CTI parameters in different MMVD stages using simultaneous ECG and PCG recordings in dogs. Furthermore, we have proven that the concept of using the newly proposed parameters from a novel device is equivalent to the Tei index. Thus, we established a novel approach to evaluate cardiac function and its supportive use in the diagnosis of MMVD patients.
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Affiliation(s)
- Karlo Romano B Gicana
- The International Graduate Program of Veterinary Science and Technology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, Los Baños, Philippines
| | - Tuchakorn Lertwanakarn
- Department of Physiology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Kittipong Tachampa
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Right Ventricular Diastolic Dysfunction after Marathon Run. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155336. [PMID: 32722206 PMCID: PMC7432325 DOI: 10.3390/ijerph17155336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/28/2022]
Abstract
It has been raised that marathon running may significantly impair cardiac performance. However, the post-race diastolic function has not been extensively analyzed. We aimed to assess whether the marathon run causes impairment of the cardiac diastole, which ventricle is mostly affected and whether the septal (IVS) function is altered. The study included 34 male amateur runners, in whom echocardiography was performed two weeks before, at the finish line and two weeks after the marathon. Biventricular diastolic function was assessed not only with conventional Doppler indices but also using the heart rate-adjusted isovolumetric relaxation time (IVRTc). After the run, IVRTc elongated dramatically at the right ventricular (RV) free wall, to a lesser extent at the IVS and remained unchanged at the left ventricular lateral wall. The post-run IVRTc_IVS correlated with IVRTc_RV (r = 0.38, p < 0.05), and IVRTc_RV was longer in subjects with IVS hypertrophy (88 vs. 51 ms; p < 0.05). Participants with measurable IVRT_RV at baseline (38% of runners) had longer post-race IVRTc_IVS (102 vs. 83 ms; p < 0.05). Marathon running influenced predominantly the RV diastolic function, and subjects with measurable IVRT_RV at baseline or those with IVS hypertrophy can experience greater post-race diastolic fatigue.
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Wright LK, McGaughy F, Kellerman M, Border WL, Sachdeva R. Prognostic significance of tissue Doppler imaging-derived myocardial performance index in pediatric patients with dilated cardiomyopathy. Pediatr Transplant 2020; 24:e13613. [PMID: 31709689 PMCID: PMC7186875 DOI: 10.1111/petr.13613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 11/27/2022]
Abstract
TDI-MPI has been shown to predict cardiovascular mortality in adults; there are a paucity of data on its use in children. We sought to determine the prognostic significance of TDI-MPI at time of DCM diagnosis in children. Patients aged ≤18 years diagnosed with DCM were included along with age- and sex-matched controls. Echo at diagnosis was analyzed to obtain standard measures of LV function, PW-MPI, and septal and LV free wall TDI-MPI. Survival analysis was used to assess the time to composite outcome of death, VAD, or transplant, stratified by TDI-MPI z-score. The study included 79 patients with DCM and 79 controls. During a median follow-up of 182 days (IQR 41-815 days), 16 underwent VAD placement, 21 underwent cardiac transplant, 6 died, and 36 had event-free survival. The median septal TDI-MPI for cases was 0.70 for patients with DCM vs 0.45 for controls (P < .001). Those with septal TDI-MPI z-scores ≥2 develop events significantly earlier than those with z-score <2 (P = .014). In multivariable analysis, TDI-MPI z-score ≥2 was significantly associated with poor outcomes (HR 2.12, 95% CI 1.06-4.23). TDI-MPI can be reliably performed in pediatric patients with DCM. A TDI-MPI z-score ≥2 at diagnosis may be associated with earlier poor outcome. Further studies evaluating the use of TDI-MPI in longitudinal follow-up of patients with DCM may be helpful in refining its clinical use.
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Affiliation(s)
- Lydia K. Wright
- Emory University School of Medicine, Atlanta, GA, USA,Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA
| | - Falon McGaughy
- Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA
| | | | - William L. Border
- Emory University School of Medicine, Atlanta, GA, USA,Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA
| | - Ritu Sachdeva
- Emory University School of Medicine, Atlanta, GA, USA,Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA
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Dimitroglou Y, Aggeli C, Alexopoulou A, Mavrogeni S, Tousoulis D. Cardiac Imaging in Liver Transplantation Candidates: Current Knowledge and Future Perspectives. J Clin Med 2019; 8:E2132. [PMID: 31817014 PMCID: PMC6947158 DOI: 10.3390/jcm8122132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular dysfunction in cirrhotic patients is a recognized clinical entity commonly referred to as cirrhotic cardiomyopathy. Systematic inflammation, autonomic dysfunction, and activation of vasodilatory factors lead to hyperdynamic circulation with high cardiac output and low peripheral vascular resistance. Counter acting mechanisms as well as direct effects on cardiac cells led to systolic or diastolic dysfunction and electromechanical abnormalities, which are usually masked at rest but exposed at stress situations. While cardiovascular complications and mortality are common in patients undergoing liver transplantation, they cannot be adequately predicted by conventional cardiac examination including transthoracic echocardiography. Newer echocardiography indices and other imaging modalities such as cardiac magnetic resonance have shown increased diagnostic accuracy with predictive implications in cardiovascular diseases. The scope of this review was to describe the role of cardiac imaging in the preoperative assessment of liver transplantation candidates with comprehensive analysis of the future perspectives anticipated by the use of newer echocardiography indices and cardiac magnetic resonance applications.
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Affiliation(s)
- Yannis Dimitroglou
- Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration General Hospital, 115 27 Athens, Greece; (C.A.); (D.T.)
| | - Constantina Aggeli
- Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration General Hospital, 115 27 Athens, Greece; (C.A.); (D.T.)
| | - Alexandra Alexopoulou
- Department of Internal Medicine and Research Laboratory, National and Kapodistrian University of Athens Medical School, Hippokration General Hospital, 115 27 Athens, Greece
| | - Sophie Mavrogeni
- Onassis Cardiac Center and National and Kapodistrian University of Athens, 176 74 Athens, Greece;
| | - Dimitris Tousoulis
- Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration General Hospital, 115 27 Athens, Greece; (C.A.); (D.T.)
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Fernandes JMG, de Oliveira Romão B, Rivera IR, Mendonça MA, Costa FDA, Lira Handro MDS, Campos O, De Paola ÂAV, Moisés VA. Clinical value of myocardial performance index in patients with isolated diastolic dysfunction. Cardiovasc Ultrasound 2019; 17:17. [PMID: 31409406 PMCID: PMC6693095 DOI: 10.1186/s12947-019-0167-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/07/2019] [Indexed: 12/22/2022] Open
Abstract
AIMS The Doppler-derived myocardial performance index (MPI) has been considered as a diagnostic and prognostic Doppler marker for many different clinical conditions. The purpose of this study was to determine the diagnostic accuracy of traditional Pulsed-wave Doppler (PWD-MPI) and Pulsed-wave tissue Doppler imaging (TDI-MPI) and the degree of agreement between these methods in patients with grade-I diastolic dysfunction (DDI) and a normal ejection fraction. METHODS Forty-seven consecutive ambulatory patients with DDI were compared to 51 healthy subjects with normal echocardiograms. All subjects underwent measurement of time intervals and MPI with PWD and pulsed TDI. RESULTS TDI-MPI and PWD-MPI were significantly higher in patients with DDI than in control subjects: 0.49 ± 0.14 vs. 0.40 ± 0.09 (P < 0.001) and 0.45 ± 0.11 vs. 0.37 ± 0.08 (P < 0.001), respectively. Cutoff values of TDI-MPI > 0.42 and PWD-MPI > 0.40 identified DDI subjects, with sensitivities of 74 and 64%; specificities of 61 and 69%; positive likelihood ratios of 1.9 and 2.0; and negative likelihood ratios of 0.42 and 0.53, respectively; no significant difference was noted between the areas under the ROC curves of TDI-MPI and PWD-MPI (P = 0.77). Bland-Altman plots showed wide limits of agreement between these indices: - 0.17 to 0.23 in healthy subjects and - 0.24 to 0.32 in DDI patients. CONCLUSION PWD-MPI and TDI-MPI showed poor clinical agreement and were not reliable parameters for the assessment of left ventricular diastolic function.
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Affiliation(s)
- José Maria Gonçalves Fernandes
- Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil.
| | - Benício de Oliveira Romão
- Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil
| | - Ivan Romero Rivera
- Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil
| | - Maria Alayde Mendonça
- Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil
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Ucar AB, Unal Akoglu E, Cimilli Ozturk T, Eyinc Y, Ak R, Demir H, Ilgezdi ZD, Onur O. Diagnostic value of Tei index for acute myocardial infarction in patients presenting to emergency department with ischemic chest pain and correlation with Hs-troponin. HONG KONG J EMERG ME 2018. [DOI: 10.1177/1024907918802735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Acute myocardial infarction is one of the most common causes of mortality in developed countries, and high-sensitive troponin test usually becomes positive within 3 h from the onset of symptoms. Myocardial perfusion index (Tei index) is a parameter measured during the echocardiographic examination. Objectives: The aim of this study is to investigate the diagnostic value of the Tei index for early diagnosis of acute myocardial infarction in the emergency department and to evaluate the correlation between the Tei index and Hs-Troponin value. Materials and Methods: A total of 129 cases were evaluated, and patients were divided into two groups according to their final diagnosis as “acute myocardial infarction (non-ST segment elevation myocardial infarction)” and “non-acute myocardial infarction” groups. Baseline and third-hour Hs-Troponin levels and Tei index values were determined, and their correlation was analyzed. Results: A total of 84 cases were diagnosed with acute myocardial infarction (non-ST segment elevation myocardial infarction), 84.5% had positive Tei index results at the time of admission while the remaining 45 patients were diagnosed as non-acute myocardial infarction and only 48.9% of them had positive Tei index. The diagnostic value of the Tei index and Hs-troponin were calculated as 79.8% and 60%; 67.9% and 60%, respectively. Also, we found that a 0.02 or more increase in the Tei index value has a 97.6 sensitivity and 97.5 specificity for the diagnosis of non-ST segment elevation myocardial infarction. A weak correlation was found between the Tei index and Hs-Troponin values in the acute myocardial infarction group (r = 0.425) and a negative correlation in non-acute myocardial infarction patients at presentation. Conclusion: It is suggested that the use of Tei index might be used as a supportive measure for the early diagnosis of acute myocardial infarction, and the deterioration of Tei index seems to be more significant than Hs-Troponin especially in ruling out acute myocardial infarction.
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Affiliation(s)
- Aslı Bahar Ucar
- Diyarbakir Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ebru Unal Akoglu
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Tuba Cimilli Ozturk
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Yalman Eyinc
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
- Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Rohat Ak
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
- Department of Emergency Medicine, Sancaktepe Sehit Prof. Dr. Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Hasan Demir
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Zeynep Demet Ilgezdi
- Department of Cardiology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ozge Onur
- Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
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de Almeida SA, Claudio ERG, Mengal V, Brasil GA, Merlo E, Podratz PL, Graceli JB, Gouvea SA, de Abreu GR. Estrogen Therapy Worsens Cardiac Function and Remodeling and Reverses the Effects of Exercise Training After Myocardial Infarction in Ovariectomized Female Rats. Front Physiol 2018; 9:1242. [PMID: 30233413 PMCID: PMC6134041 DOI: 10.3389/fphys.2018.01242] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/16/2018] [Indexed: 01/24/2023] Open
Abstract
There is an increase in the incidence of cardiovascular events such as myocardial infarction (MI) after menopause. However, the use of estrogen therapy (E2) remains controversial. The aim of this study was to evaluate the effects of E2, alone and combined with exercise training (ET), on cardiac function and remodeling in ovariectomized (OVX) rats after MI. Wistar female rats underwent ovariectomy, followed by MI induction were separated into five groups: S; MI; MI+ET; MI+E2; and MI+ET+E2. Fifteen days after MI or sham surgery, treadmill ET and/or estrogen therapy [17-β estradiol-3-benzoate (E2), s.c. three times/week] were initiated and maintained for 8 weeks. After the treatment and/or training period, the animals underwent cardiac hemodynamic evaluation through catheterization of the left ventricle (LV); the LV systolic and diastolic pressures (LVSP and LVEDP, respectively), maximum LV contraction and relaxation derivatives (dP/dt+ and dP/dt−), and isovolumic relaxation time (Tau) were assessed. Moreover, histological analyses of the heart (collagen and hypertrophy), cardiac oxidative stress [advanced oxidation protein products (AOPPs)], pro- and antioxidant protein expression by Western blotting and antioxidant enzyme activity in the heart were evaluated. The MI reduced the LVSP, dP/dt+ and dP/dt− but increased the LVEDP and Tau. E2 did not prevent the MI-induced changes in cardiac function, even when combined with ET. An increase in the dP/dt+ was observed in the E2 group compared with the MI group. There were no changes in collagen deposition and myocyte hypertrophy caused by the treatments. The increases in AOPP, gp91-phox, and angiotensin II type 1 receptor expression induced by MI were not reduced by E2. There were no changes in the expression of catalase caused by MI or by the treatments, although, a reduction in superoxide dismutase (SOD) expression occurred in the groups subjected to E2 treatment. Whereas there were post-MI reductions in activities of SOD and catalase enzymes, only that of SOD was prevented by ET. Therefore, we conclude that E2 therapy does not prevent the MI-induced changes in cardiac function and worsens parameters related to cardiac remodeling. Moreover, E2 reverses the positive effects of ET when used in combination, in OVX infarcted female rats.
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Affiliation(s)
- Simone Alves de Almeida
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Erick R G Claudio
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Vinicius Mengal
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Girlandia A Brasil
- Núcleo de Pesquisas em Ciências Farmacêuticas - Nupecfarma, Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Vila Velha, Vila Velha, Brazil
| | - Eduardo Merlo
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Priscila L Podratz
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Jones B Graceli
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Sonia A Gouvea
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Gláucia Rodrigues de Abreu
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
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Tang Y, Zhu S, Chen J, Hua L. R-Wave Modified Tissue Doppler Imaging Myocardial Performance Index for the Assessment of Cardiac Function in Children with Congestive Heart Failure: A Feasibility Study. Med Sci Monit 2018; 24:5225-5231. [PMID: 30054453 PMCID: PMC6078010 DOI: 10.12659/msm.908687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to evaluate the feasibility of an R-wave modified tissue Doppler imaging (TDI) myocardial performance index (MPI), or MPI TDI-R, for the assessment of cardiac function in children with congestive heart failure (CHF). Material/Methods Forty children with CHF and 40 normal children were evaluated using the modified pediatric Ross heart failure grading system. TDI recorded the spectrum of diastolic function at the mitral valve annulus to measure the MPI. Twelve-lead electrocardiogram (ECG) measured the R-wave in the QRS complex, resulting in the modified MPI TDI-R. Correlation between the MPI TDI-R, other echocardiographic indices, and the Ross heart failure grades were analyzed, with reproducibility analysis. Results Compared with normal children, the MPI TDI and MPI TDI-R were significantly increased in the pediatric CHF group (P<0.01). The MPI TDI-R was significantly correlated with other indices of cardiac function and Ross grading for CHF in children (r=0.769). The MPI TDI-R showed good correlation with the findings of the MPI TDI, calculated by traditional methods. Receiver-operating characteristic (ROC) curve analysis showed that the MPI TDI-R had a sensitivity of 67.5%, and a specificity of 97.5%. The reproducibility of the MPI TDI-R was confirmed to be superior when compared with the non-modified MPI TDI. Conclusions This feasibility study showed that the modified MPI TDI-R, formed by combining the MPI TDI with synchronous surface ECG measurements, was simple to perform, reproducible, and provided a specific index for the assessment of cardiac function in children with CHF.
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Affiliation(s)
- Ying Tang
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Shanliang Zhu
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Jun Chen
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Lichun Hua
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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Biering-Sørensen T, Mogelvang R, de Knegt MC, Olsen FJ, Galatius S, Jensen JS. Cardiac Time Intervals by Tissue Doppler Imaging M-Mode: Normal Values and Association with Established Echocardiographic and Invasive Measures of Systolic and Diastolic Function. PLoS One 2016; 11:e0153636. [PMID: 27093636 PMCID: PMC4836694 DOI: 10.1371/journal.pone.0153636] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/01/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To define normal values of the cardiac time intervals obtained by tissue Doppler imaging (TDI) M-mode through the mitral valve (MV). Furthermore, to evaluate the association of the myocardial performance index (MPI) obtained by TDI M-mode (MPITDI) and the conventional method of obtaining MPI (MPIConv), with established echocardiographic and invasive measures of systolic and diastolic function. METHODS In a large community based population study (n = 974), where all are free of any cardiovascular disease and cardiovascular risk factors, cardiac time intervals, including isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and ejection time (ET) were obtained by TDI M-mode through the MV. IVCT/ET, IVRT/ET and the MPI ((IVRT+IVCT)/ET) were calculated. We also included a validation population (n = 44) of patients who underwent left heart catheterization and had the MPITDI and MPIConv measured. RESULTS IVRT, IVRT/ET and MPI all increased significantly with increasing age in both genders (p<0.001 for all). IVCT, ET, IVRT/ET, and MPI differed significantly between males and females, displaying that women, in general exhibit better cardiac function. MPITDI was significantly associated with invasive (dP/dt max) and echocardiographic measures of systolic (LVEF, global longitudinal strain and global strainrate s) and diastolic function (e', global strainrate e)(p<0.05 for all), whereas MPIConv was significantly associated with LVEF, e' and global strainrate e (p<0.05 for all). CONCLUSION Normal values of cardiac time intervals differed between genders and deteriorated with increasing age. The MPITDI (but not MPIConv) is associated with most invasive and established echocardiographic measures of systolic and diastolic function.
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Affiliation(s)
- Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Mogelvang
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Martina Chantal de Knegt
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Javier Olsen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Søren Galatius
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jan Skov Jensen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Fattouh AM, El-Shabrawi MH, Mahmoud EH, Ahmed WO. Evaluation of cardiac functions of cirrhotic children using serum brain natriuretic peptide and tissue Doppler imaging. Ann Pediatr Cardiol 2016; 9:22-8. [PMID: 27011687 PMCID: PMC4782463 DOI: 10.4103/0974-2069.171373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cirrhotic cardiomyopathy (CCM) is described as the presence of cardiac dysfunction in cirrhotic patients. In children with chronic liver disease, CCM has been very rarely investigated. THE AIM OF THE STUDY Is to evaluate the cardiac function of cirrhotic children to identify those with CCM. PATIENTS AND METHODS Fifty-two cirrhotic patients and 53 age and sex matched controls were assessed using serum brain-type natriuretic peptide (BNP), conventional echocardiography, and tissue Doppler imaging. RESULTS Patients' mean ages were 7.66 ± 4.16 years (vs. 6.88 ± 3.04 years for the controls). The study included 27 males and 25 females (28 and 25 respectively for the controls). Patients had larger left atrium and right ventricle (RV) (P value 0.05) and increased LV posterior wall thickness than controls (P value 0.04). They had higher late atrial diastolic filling velocity (A) of tricuspid valve (TV) inflow (0.59 ± 0.17 vs. 0.5 ± 0.1 m/s, P < 0.001) and lower ratios between the early diastolic filling velocity (E) and A wave velocity (E/A) of both mitral valve and TV inflow (1.7 ± 0.35 vs. 1.87 ± 0.34 and 1.3 ± 0.3 vs. 1.5 ± 0.3, P < 0.005 and 0.0008, respectively). Patients had significantly longer isovolumic relaxation time of LV (45.5 ± 11.1 vs. 40.5 ± 7.7 ms P 0.008), higher late diastolic peak myocardial velocity (A') (11.8 ± 3.6 vs. 9.5 ± 2.7 ms, P 0.0003) and systolic velocity (S') of the RV (14.5 ± 2.7 vs. 13.2 ± 2.9, P 0.01) and significantly higher myocardial performance index of both LV and RV (P 0.001 and 0.01). BNP levels were significantly higher in cases than controls (5.25 ng/l vs. 3.75 ng/l, P < 0.04) and was correlated with the E wave velocity of the TV (r 0.004) and the E/E' ratio of the RV (r 0.001). None of the clinical or laboratory data were correlated with the BNP level. CONCLUSION Cirrhotic children have cardiac dysfunction mainly in the form of diastolic dysfunction. There is a need that CCM be more accurately described in children.
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Affiliation(s)
- Aya M Fattouh
- Department of Pediatrics, Cairo University, Cario, Egypt
| | | | - Enas H Mahmoud
- Department of Chemical Pathology, Cairo University, Cario, Egypt
| | - Wafaa O Ahmed
- Department of Pediatrics, Cairo University, Cario, Egypt
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Zhang Q, Xue M, Li Z, Wang H, Zhu L, Liu X, Meng H, Hou Y. Effects of an Isolated Complete Right Bundle Branch Block on Mechanical Ventricular Function. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:2171-2177. [PMID: 26491093 DOI: 10.7863/ultra.14.10069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/07/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the effects of an isolated complete right bundle branch block on mechanical ventricular function. METHODS Two groups of participants were enrolled in this study: a block group, consisting of 98 patients with isolated complete right bundle branch blocks without structural heart disease, and a control group, consisting of 92 healthy adults. The diameter, end-diastolic area, end-systolic area, and right ventricular (RV) fractional area change were obtained to evaluate morphologic and systolic function by 2-dimensional sonographic technology. Systolic and diastolic velocities and time interval parameters were measured to assess mechanical ventricular performance using pulsed wave tissue Doppler imaging. RESULTS Although there was no significant difference in the RV fractional area change between the patients with blocks and controls, the diameter, end-diastolic area, and end-systolic area of the RV were significantly larger in the patients with blocks (P < .05). In the patients with blocks, the peak velocities during systole and early diastole and the ratio of the peak velocities during early and late diastole decreased. The block group had a prolonged pre-ejection period, electromechanical delay time, and isovolumic relaxation time, a decreased ejection time, and an increased pre-ejection period/ejection time ratio, and the myocardial performance index (Tei index) at the basal RV lateral wall was significantly increased. There were no significant differences in any echocardiographic parameters at different sites of the left ventricle. CONCLUSIONS In patients with isolated complete right bundle branch blocks, systolic and diastolic functions are impaired in the RV, and follow-up is needed.
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Affiliation(s)
- Qin Zhang
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Minghua Xue
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Zhan Li
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Haiyan Wang
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Lei Zhu
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Xinling Liu
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Haiyan Meng
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China
| | - Yinglong Hou
- From the from the Department of Cardiology, Shandong Traffic Hospital, Jinan, China (Q.Z., L.Z., X.L., H.M.); and Departments of Echocardiography (M.X., H.W.) and Cardiology (Y.H.), Shandong Provincial Qianfoshan Hospital, and School of Medicine (Z.L.), Shandong University, Jinan, China.
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Han X, Ge M, Dong J, Wang Z, He J, Yang R. The relationship between left ventricle myocardial performance index of healthy women and geographical factors. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1557-1565. [PMID: 25663471 DOI: 10.1007/s00484-015-0962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/08/2015] [Accepted: 01/08/2015] [Indexed: 06/04/2023]
Abstract
The study focused on the relationship between geographical factors and left ventricular myocardial performance index (MPI)reference value, analyed the different distribution of MPI, and then provided a scientific basis for clinical examination. This study collected MPI reference values of 2545 healthy women from 91 cities in China, used the Moran's index to determin the spatial relationship, selected 25 geographical factors, examined the significance between MPI and geographical factors by correlation analysis, through the significance test, and extracted seven significant factors to build the artificial neural network (ANN) model and principal component analysis (PCA) model. Through calculating the relative error, the ANN model was chosen as the better model to predict the values. By normality test for the predicted values, the geographical distribution was made by disjunctive kriging interpolation. The predicted values decrease from north to south. If geographical factors are obtained in one location, the MPI of healthy women in this area can be predicted by the ANN model. Synthesizing the influence of physiological and geographical could be more scientific to formulate the MPI reference value.
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Affiliation(s)
- Xiao Han
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China.
| | - Miao Ge
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China.
| | - Jie Dong
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Zixuan Wang
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Jinwei He
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Rongrong Yang
- College of Tourist and Environment Science, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
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CERCENELLI L, MARCELLI E. CARDIAC APEX ROTATION ASSESSED BY AN IMPLANTABLE GYRO SENSOR: CORRELATION WITH A LV PRESSURE-DERIVED MYOCARDIAL PERFORMANCE INDEX IN EXPERIMENTALLY INDUCED ISCHEMIA. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415400138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite many investigators have focused attention on cardiac apex rotation (CAR) as a sensitive marker of left ventricle (LV) function, no studies have been specifically aimed to evaluate the correlation of CAR with myocardial performance index (MPI), a well-known index of both systolic and diastolic performance. In four sheep, we measured CAR using a miniature gyro sensor epicardically positioned at LV apex and we evaluated the beat-to-beat correlation between CAR and a myocardial performance index calculated from LV-pressure (LVP) measurements (MPILVP). We also compared CAR with hemodynamic parameters (LVdP/dtMAX, LVdP/dtMIN). A strong negative correlation was observed between CAR and MPILVP during the experimental cardiac conditions (baseline, acute ischemia induced by coronary ligation and release of ligation). At 30 s after ligation a marked decrease of CAR was observed, while LVdP/dtMAX showed minor changes. CAR has good potential to reflect changes of global myocardial performance and to predict hemodynamic changes in acute impairment of cardiac function.
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Affiliation(s)
- L. CERCENELLI
- Experimental Diagnostic and Specialty Medicine Department, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - E. MARCELLI
- Experimental Diagnostic and Specialty Medicine Department, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
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