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Myocardial Performance Index (myocardial + performance_index)

Distribution by Scientific Domains

Medical Sciences	91%

Selected Abstracts

The Effects of Antihypertensive Treatment on the Doppler-Derived Myocardial Performance Index in Patients with Hypertensive Left Ventricular Hypertrophy: Results from the Swedish Irbesartan in Left Ventricular Hypertrophy Investigation Versus Atenolol (SILVHIA)

ECHOCARDIOGRAPHY, Issue 7 2009
Stefan Liljedahl M.D.
Objectives: To investigate the effects of antihypertensive treatment on the Doppler-derived myocardial performance index (MPI) in patients with hypertensive left ventricular hypertrophy. Methods: The MPI was measured at baseline and after 48 weeks of antihypertensive treatment in 93 participants of the SILVHIA trial, where individuals with primary hypertension and left ventricular hypertrophy were randomized to double blind treatment with either irbesartan or atenolol. Results: Antihypertensive treatment lowered MPI (mean difference ,0.03 ± 0.01, P = 0.04). Changes in MPI by treatment were associated with changes in left ventricular ejection fraction (,-coefficient ,0.35 P = 0.005), stroke volume/pulse pressure (reflecting arterial compliance, ,-coefficient ,0.39 P < 0.001) and peripheral vascular resistance (,-coefficient 0.28 P < 0.04). Furthermore, there was a borderline significant association between changes in MPI and changes in E-wave deceleration time (reflecting diastolic function, ,-coefficient 0.23, P = 0.06). No associations were found between changes in MPI and changes in blood pressure, E/A-ratio, left ventricular mass index, relative wall thickness or heart rate. A stepwise multivariable regression model confirmed the association between changes in MPI and changes in ejection fraction and stroke volume/pulse pressure (all P < 0.05), as well as the trend for E-wave deceleration time (P = 0.08), but not in the case of peripheral vascular resistance. Conclusion: The MPI exhibited a modest decrease after 48 weeks of antihypertensive treatment in patients with hypertensive left ventricular hypertrophy. Changes in MPI were associated with changes in left ventricular function and vascular compliance, rather than with changes in left ventricular remodeling or blood pressure. [source]

Myocardial Performance Index (Tei Index) Does Not Reflect Long-Term Changes in Left Ventricular Function after Acute Myocardial Infarction

ECHOCARDIOGRAPHY, Issue 1 2003
Torstein Hole M.D.
Aims: To evaluate whether changes in myocardial performance index (MPI or Tei index) were related to changes in other Doppler echocardiographic parameters after acute myocardial infarction, or had any independent prognostic impact in a 2-year observational study. Methods and Results: Seventy-one patients with acute myocardial infarction without heart failure were examined at baseline, 3 months, and 2 years. MPI was significantly related to end-diastolic and end-systolic volume indexes, ejection fraction, maximal velocity, and time velocity integral of early mitral filling wave at 3 months and 2 years. MPI did not contribute significantly to the prediction of any changes in the measures of diastolic or systolic function at 3 months or 2 years. Baseline MPI was significantly higher in patients who later developed heart failure(0.55 ± 0.16)than in other patients(0.43 ± 0.13, P = 0.006), but had no independent predictive power for the development of heart failure or death relative to end-systolic volume index and deceleration time of early mitral filling wave. Conclusion: MPI did not accurately reflect changes in Doppler and two-dimensional echocardiographic measures of diastolic or systolic function during a 2-year follow-up after acute myocardial infarction, and did not have any independent prognostic impact. (ECHOCARDIOGRAPHY, Volume 20, January 2003) [source]

Acute Adaptation to Volume Unloading of the Functional Single Ventricle in Children Undergoing Bidirectional Glenn Anastomosis

CONGENITAL HEART DISEASE, Issue 2 2009
Catherine Ikemba MD
ABSTRACT Objective., Volume unloading of the functional single ventricle after a bidirectional Glenn anastomosis (BDG) prior to 1 year of age leads to improved global ventricular function as measured by the myocardial performance index (MPI), a Doppler-derived measurement of combined systolic and diastolic ventricular function. Systolic function remains unchanged after BDG according to previous studies; however, acute changes in global and diastolic function have not been previously investigated in this cohort. Our objective was to assess the short-term effects of the BDG on global ventricular function in patients with a functional single ventricle. Design., Echocardiograms to obtain MPI, isovolumic contraction time, and isovolumic relaxation time were performed at four time periods: in the operating room, in the operating room prior to BDG, shortly after separation from cardiopulmonary bypass, less than 24 hours postoperatively, and either prior to hospital discharge or at the first clinic follow-up visit. Results., Twenty-six patients were enrolled. There was significant ventricular dysfunction noted shortly after separation from cardiopulmonary bypass, median MPI 0.63 (0.39,0.81), that persisted in the short term postoperatively median MPI 0.50 (0.40,0.63). Isovolumic contraction time did not change, however, isovolumic relaxation time was significantly prolonged following BDG. Conclusion., In the postoperative patient after BDG, systolic function is preserved; however, there is evidence of diastolic and global ventricular dysfunction, at least in the short term. [source]

Identifying Left Ventricular Dysfunction in Pulmonary Hypertension

CONGESTIVE HEART FAILURE, Issue 5 2009
Navin Rajagopalan MD
The significance of left ventricular (LV) dysfunction in patients with pulmonary hypertension (PH) is unknown. Our purpose was to quantify LV function in PH patients by measuring LV myocardial performance index (MPI) and correlating it with invasively determined hemodynamic variables. The authors prospectively measured LV MPI via transthoracic echocardiography in 50 patients with PH (53±11 years; 35 women) who also underwent right heart catheterization within 1 day of echocardiography. For comparative purposes, LV MPI was also measured in 15 healthy volunteers who served as controls. LV MPI was significantly increased in the PH group compared with controls (0.62±0.27 vs 0.36±0.08; P<.001), indicating worse LV dysfunction despite that LV ejection fraction was not significantly different between the groups (58%±4% vs 60%±3%). LV MPI demonstrated significant correlations with invasively determined mean pulmonary artery pressure (r=.50; P<.001), pulmonary vascular resistance (r=.57; P<.001), and cardiac index (r=,.64; P<.001). By receiver operating characteristic analysis, LV MPI >0.75 predicted cardiac index <2 L/min/m2 with 89% sensitivity and 78% specificity (area under the curve, 0.89). In a multivariate model, LV MPI was independently associated with cardiac index (P<.01). Patients with PH demonstrate abnormal LV function as quantified by elevated LV MPI, which correlates significantly with pulmonary vascular resistance and cardiac index. [source]

The Effects of Antihypertensive Treatment on the Doppler-Derived Myocardial Performance Index in Patients with Hypertensive Left Ventricular Hypertrophy: Results from the Swedish Irbesartan in Left Ventricular Hypertrophy Investigation Versus Atenolol (SILVHIA)

Evaluation of Subendocardial and Subepicardial Left Ventricular Functions Using Tissue Doppler Imaging after Complete Revascularization

ECHOCARDIOGRAPHY, Issue 2 2009
Hüseyin Sürücü M.D.
Objective: We aim to evaluate subepicardial and subendocardial left ventricular (LV) functions in patient single coronary artery lesion at early stage after percutaneous coronary intervention (PCI). Additionally, a comparison of LV functions between patients and control cases was aimed. Method: Patients with culprit left anterior descending (LAD) lesion (n = 25) and subjects with normal coronary angiography (n = 25) were evaluated. Patients underwent PCI and at least one coronary stent was placed. After PCI, the pulsed-wave tissue Doppler imaging (pw-TDI) parameters taken from subepicardial and subepicardial layers were compared among the patients. Results: Left atrium (P = 0.050), LV end-diastolic (P = 0.049), and end-systolic (P = 0.006) diameters were larger compared to the control group. LV inflow velocities were not different between the patient and the control group. But, the myocardial performance index was different (P = 0.049). The systolic and diastolic pw-TDI parameters were apparently different between the patient and the control group. While the systolic pw-TDI parameters did not change, the diastolic pw-TDI parameters taken from both subepicardial (circumferential contraction) and subendocardial layers (longitudinal contraction) improved after PCI. After PCI, it was shown that while Ea velocity (P = 0.012) taken from the subendocardial layer increased, IVRa velocity (P < 0.001) taken from the subepicardial layer decreased. Conclusion: In our study, it could be said that LV, left atrium, and aortic valve diameter increase in patients with coronary artery disease. The systolic and diastolic functions were impaired at subendocardial and subepicardial layers. These dysfunctions can be easily presented with pw-TDI. Although systolic dysfunction persists, diastolic dysfunction improves at early stage after PCI. [source]

A New Echocardiographic Index for Assessing Left Ventricular Function and Mechanism of Mitral Regurgitation and Its Relation to Other Echocardiographic Indices

ECHOCARDIOGRAPHY, Issue 6 2007
Cemal Sag M.D.
Objective: Mitral regurgitation (MR) is a progressive disease of the mitral valve, which can be primary or functional. The assessment of left ventricular function in MR is still troublesome. In this study, we evaluated the validity of a new parameter, total dt, in patients with MR. Methods: Forty patients with severe MR constituted the study group. According to the transesophageal echocardiographic evaluation, the patients were dichotomized into two groups: (1) Primary MR; n = 21, (2) Functional MR; n = 19. The total dt was defined as the sum of time intervals from 1 msto 3 ms (positive dt) and from 3 ms to 1 ms (negative dt) on the CW Doppler recording of MR jet. It was compared to other indices of left ventricular function and left ventricular geometry, including ejection fraction, fractional shortening, myocardial performance index, coaptation distance, left ventricular volume and diameter, sphericity index, and parameters of diastolic function. Result: The total dt correlated with myocardial performance index, coaptation distance, and sphericity index. It could differentiate between primary and functional MR with an area under curve of 0.878, followed by myocardial performance index with 0.860. The total dt > 104 ms was 79% sensitive and 81% specific for discrimination. Conclusion: The total dt is useful for assessing left ventricular function and also for differentiating primary MR from functional MR. [source]

Myocardial Performance Index (Tei Index) Does Not Reflect Long-Term Changes in Left Ventricular Function after Acute Myocardial Infarction

The Myocardial Performance Index in Patients with Aortic Stenosis

ECHOCARDIOGRAPHY, Issue 4 2002
Jude A. Mugerwa M.D.
Objectives: This study was designed to determine the effect of chronic afterload on a Doppler-derived myocardial performance index (MPI) combining both systolic and diastolic left ventricular dysfunction. Methods: The study included 36 patients with a diagnosis of aortic stenosis and 36 normal subjects. Doppler-derived myocardial performance index (MPI), defined as the sum of the isovolumic contraction time and isovolumic relaxation time divided by ejection time, was measured from the mitral valve inflow and left ventricular outflow velocity patterns and was then related to the aortic valve area, valve gradient, and other echocardiographic variables. Results: The values of the Doppler-derived MPI in the patients with aortic stenosis were significantly higher than those in the controls (0.54 ± 0.20 vs 0.38 ± 0.04, respectively; P < 0.001). Transmitral deceleration time and the E/A ratio (r = 0.47 and r = 0.35, respectively; P < 0.05) were significant univariate correlates, and mitral deceleration time was the only significant correlate of MPI. However the index did not correlate with aortic valve area, peak and mean valve gradients, left ventricular mass, or age. Conclusions: Doppler-derived MPI reflects severity of global left ventricular dysfunction in patients with aortic stenosis and may be of clinical value in this patient population. [source]

Methods for prenatal assessment of fetal cardiac function

PRENATAL DIAGNOSIS, Issue 13 2009
Tim Van Mieghem
Abstract Fetal cardiac function is increasingly recognized as a marker of disease severity and prognosis in selected fetal conditions. Magnetic resonance imaging (MRI) has been used in experimental (animal) fetal cardiology but the lack of a noninvasive fetal electrocardiogram (ECG) to trigger image acquisition remains a major limiting factor precluding its application in humans. Fetal medicine specialists are therefore limited to ultrasound to evaluate human fetal cardiac function. In this review, we aim to provide a complete overview of the different ultrasound techniques that can be used for fetal cardiac function assessment and we discuss their (theoretical) strengths and shortcomings. Conventional methods include M-mode assessment of ventricular contractility and Doppler assessment of the precordial veins and cardiac output (CO). More recent techniques such as the measurement of the myocardial performance index (MPI), myocardial motion analysis with tissue Doppler, speckle tracking and three-dimensional (3D) ultrasound techniques are also discussed. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Evaluation of Biventricular Functions With Tissue Doppler Imaging in Patients With Myotonic Dystrophy

CLINICAL CARDIOLOGY, Issue 3 2010
Tolga Ozyigit MD
Background: Myotonic dystrophy (MD) is characterized by myotonia with dystrophic involvement of the muscles. Cardiac involvement is usually not evident in the early stages of MD. Hypothesis: We investigated biventricular functions by tissue Doppler imaging (TDI) in MD patients with no overt cardiac involvement to explore the value of TDI in the early detection of myocardial dysfunction. Methods: A total of 21 MD patients (15 male, age: 32.2 ± 12.3 yrs) and 21 healthy controls (13 male, age: 32.2 ± 7.8 yrs) were included. In addition to conventional echocardiography, pulsed Doppler and TDI were performed including measurement of myocardial performance index (MPI); peak systolic (Sm) and early (Em) and atrial (Am) diastolic myocardial velocities at the basal mitral and tricuspid annulus. Results: All patients and controls had normal ejection fraction. Transmitral E peak velocity was significantly lower while both deceleration time of E velocity and isovolumic relaxation time were significantly longer in MD patients (P = 0.007, P = 0.001, and P < 0.001, respectively). Sm, Em and Am peak velocities were significantly lower in MD patients in all segments except for Em of the mitral anterior annulus and Am of the tricuspid lateral annulus. Both left and right ventricular MPI were significantly higher in MD patients (P < 0.001 and P = 0.013, respectively). Conclusion: There are changes in myocardial systolic and diastolic functions in MD patients although they have no overt heart failure. Myocardial tissue velocities and MPI are useful in identifying subclinical biventricular involvement in these patients. Copyright © 2010 Wiley Periodicals, Inc. [source]

Disturbed glucose metabolism is associated with left ventricular dysfunction using tissue Doppler imaging in patients with myocardial infarction

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 1 2007
Loghman Henareh
Summary Aims:, To investigate the association between glucose abnormalities and left ventricular (LV) function assessed by tissue Doppler imaging (TDI) in patients with previous history of myocardial infarction and without known diabetes mellitus. Patients and methods:, In a cross-sectional study, 123 patients, aged 31,80 years, with a history of previous myocardial infarction and without known diabetes mellitus were examined with TDI echocardiography. A standard oral glucose test (OGTT) with 75 g of glucose was performed. Results:, Two-hour plasma glucose were significantly and negatively associated with TDI parameters such as LV ejection time; early diastolic filling velocity (E,- v); ratio of the early to late diastolic filling velocity (E,/A,) and positively associated with regional myocardial performance index (MPI) (P<0·05). Left ventricular ejection time and MPI were significantly higher; E,/A, and E,- v were significantly lower in patients with disturbed glucose metabolism compared with patients with normal glucose tolerance (P<0·01). These differences remain significant also when the patients with DM were excluded. Conclusions:, The present study demonstrates that disturbed glucose metabolism is associated with more pronounced LV dysfunction using TDI in patients with myocardial infarction. These abnormalities in LV function were more common not only in subjects with diabetes, but also in patients with prediabetic condition, impaired glucose intolerance. [source]