The Agreement Analysis Of Tei Index Drived By Pulse Doppler And Tissue Doppler Imaging Used To Assess Left Ventricular Diastolic Function

Objective To analyze the agreement of Myocardial Performance Index (Tei index)drived by pulse doppler and tissue doppler imaging (TDI) and investigate the value of Teiindex for estimating left ventricular diastolic function.Methods140cases of clinical diagnosis of patients with left ventricular diastolicdysfunction were selected as case group, who were divided into moderate left ventriculardiastolic dysfunction group (group A) and mild left ventricular diastolic dysfunctiongroup (group B) on the basis of echocardiography pulse doppler mitral flow E/A ratio andtissue doppler spectrum of mitral annular velocity Ea/Aa ratio. Group A:1<E/A<2，Ea/Aa <1; Group B: E/A <1，Ea/Aa <1. In the same period,80age and gender matchedhealthy adults were selected as the control group (group C). All study objects wereexamined by normal echocardiography. Pulse Doppler Tei index was calculated frompulse doppler flow spectrum of mitral and aortic valve. TDI Tei index was calculatedfrom PW-TDI spectrum of the septal and lateral corner of mitral annular. The mitralannular (septal and lateral) early (Ea) and late (Aa) diastolic peak velocity were measuredby PW-TDI spectrum too. The average (Ea) and (Aa) were treated as the movementindicators of the overall mitral annular.Results1Tei index decreases in the group A, group B and group C: pulse Doppler Teiindex [(0.54±0.06) vs (0.46±0.07) vs (0.36±0.06)], lateral TDI Tei [(0.54±0.06) vs(0.46±0.07) vs (0.36±0.06)], septal TDI Tei index [(0.56±0.07) vs (0.48±0.07) vs(0.38±0.06)], average TDI Tei index [(0.55±0.06) vs (0.47±0.07) vs (0.37±0.06)],with statistically significant difference (P<0.01).2Pulse doppler Tei index werenegatively correlated with LVEF (rs=－0.29, P<0.01), E peak (rs=－0.23, P<0.01),Ea/Aa (rs=－0.57, P<0.01), and positively correlated with Aa (rs=0.30, P<0.01), E/Ea(rs=0.56, P<0.01).3Pulse doppler Tei index were well correlated with TDI Tei index.The good agreement between pulse Doppler Tei index and TDI Tei index were showed inBland-Altman figures.4The sensitivity and specificity of Tei index were higher foridentifying left ventricular diastolic dysfunction. Pulse doppler Tei index cutoff value of≥0.455identified abnormal left ventricular diastolic function with a sensitivity of76.7%and specificity of98.7%, lateral TDI Tei index cutoff value of≥0.443identified abnormal left ventricular diastolic function with a sensitivity of78.6%and specificity of98.7%Conclusion The consistency of pulse doppler Tei index and tissue Doppler Tei index iswell. Tei index increases with the the deterioration of left ventricular diastolicdysfunction and has certain relevance with conventional ultrasonic left ventricularfunction parameters. Tei index reveals high diagnostic value in identifying left ventriculardiastolic dysfunction. TDI Tei index measured more quickly and conveniently may bebetter for practical application due to its higher precision.