Korean Circ J.  2010 Mar;40(3):114-118. 10.4070/kcj.2010.40.3.114.

Segmental Tissue Doppler Image-Derived Tei Index in Patients With Regional Wall Motion Abnormalities

• Baek HK
• Park TH
• Park JS
• Seo JM
• Park SY
• Kim BG
• Kim SO
• Cha KS
• Kim MH
• Kim YD

• KMID: 2094070
• DOI: http://doi.org/10.4070/kcj.2010.40.3.114

Abstract

BACKGROUND AND OBJECTIVES
Although the Tei index is a useful predictor of global ventricular function, it has not been investigated at the level of regional myocardial function. We therefore investigated the segmental tissue Doppler image derived-Tei index (TDI-Tei index) in patients with regional wall motion abnormalities. SUBJECTS AND METHODS: We prospectively studied 17 patients (mean age 62+/-9 years, 5 women) with left ventricular (LV) regional wall motion abnormalities. The Tei index, defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET), was measured in the basal and mid segments of the LV walls from standard apical views (4-, 2-, and 5-chamber views). We also obtained TDI velocity data in each segment. LV wall motion was classified as normal, hypokinetic, or akinetic, based on visual analysis. The TDI-Tei index, peak systolic myocardial velocity (Sm), early diastolic myocardial velocity (Em), and late diastolic myocardial velocity (Am) were analyzed in a total of 203 segments. RESULTS: Mean LV ejection fraction was 41.8+/-8.5%. TDI-Tei indices of dysfunctional segments (akinesis or hypokinesis, n=63) were significantly higher than those of normal segments (n=140) (0.714+/-0.169 vs. 0.669+/-0.135, p=0.041, respectively). Average values of TDI-Tei index, Sm, Em, and Am were 0.742+/-0.201, 4.206+/-1.336, 5.258+/-1.867, and 5.578+/-2.354 in akinetic segments; 0.677+/-0.101, 4.908+/-1.615, 5.369+/-2.121, and 5.542+/-2.492 in hypokinetic segments; and 0.669+/-0.135, 5.409+/-1.519, 6.108+/-2.356, and 6.719+/-2.466 in normal segments, respectively. A significant negative correlation was apparent between the TDI-Tei index and Sm (r=-0.302, p<0.001). CONCLUSION: These data suggest that the value of the segmental TDI-Tei index differs significantly according to regional function grade.

Keyword

Echocardiograph, Doppler; Myocardial contraction; Ventricular function

MeSH Terms

Contracts
Humans
Myocardial Contraction
Prospective Studies
Relaxation
Ventricular Function

Figure

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  Fig. 1 A representative case of measurements for calculation of the TDI-Tei index. IVRT: isovolumetric relaxation time, IVCT: isovolumetric contraction time, ET: ejection time, TDI-Tei index: tissue Doppler image derived Tei index.

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  Fig. 2 Correlation of conventional Tei index and TDI-Tei index. TDI-Tei index: tissue Doppler image derived Tei index.

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  Fig. 3 Differences in TDI-Tei indices and peak systolic myocardial velocities among akinetic, hypokinetic, and normal myocardial segments. Sm: peak systolic myocardial velocity, TDI-Tei index: tissue Doppler image derived Tei index.

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  Fig. 4 Correlation of TDI-Tei index and peak systolic myocardial velocity. Sm: peak systolic myocardial velocity, TDI-Tei index: tissue Doppler image derived Tei index.

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