The Roles Of Tei Index In The Evaluation Of Cardiac Function In Patients With Bisoprolol

Background: In patients with coronary artery diseases, the onset of heart failure is associated with long-term coronary ischemia and myocardial infarction. As is known to all, beta-blockers contribute to reduce mortality and improve cardiac function in patients with left ventricular dysfunction. Tei index is a Doppler-derived index of combining systolic and diastolic function which has shown to be a sensitive indicator of overall cardiac dysfunction in patients with cardiovascular diseases. But its value in clinical practice remains controversial. Thus, this paper focus on Tei index in the evaluation of cardiac function in percutaneous coronary intervention(PCI) patients who treated by bisoprolol.Objective: To determine the roles of Tei index in the evaluation of cardiac function in PCI patients with bisoprolol.Methods: In Dalian Medical University Affiliated NO.1 Hospital, a total of 118 patients refered to this test, male 83, female 35, average age was 65.4±10.4 years. All of these patients treated with bisoprolol to limit the resting heart rate between 55 and 60 times/min. The patients were examined by professional heart ultrasound doctors using PHILIPS IE ILITE ultrasonic diagnostic instrument to recorded left ventricular ejection fraction(LVEF), E/A value and Tei index. Meanwhile, heart rate and blood pressure were recorded. Follow up all the patients at 6 months(M6), 18 months, enrolled echocardiographic results, heart rate, blood pressure and major adverse cardiac events(MACE).Results: All patients’ average Tei index was 1.005 ± 0.380 before therapy, at 6 months, the results were 0.935 ± 0.283 which lower than before therapy, there were statistically significant difference(p = 0.021); at 18 months the results were 0.882± 0.359, it is lower than before therapy, there were statistically significant difference(p < 0.001). Before therapy, average LVEF was 56.373 ± 5.854%, at 6 months the results were 57.390 ± 6.117% on average, which higher than before therapy, there were statistically significant difference(p =0.003); at 18 months the results were 57.458 ± 5.594%, which higher than before therapy, there were statistically significant difference(p = 0.001). Before therapy group, the average E/A ratio was 0.825 ± 0.345, at 6 months the results were 0.846 ± 0.275, which higher than before therapy, there were not statistically significant difference(p = 0.310); at 18 months, the results were 0.869 ± 0.355, which higher than before therapy, there were not statistically significant difference(p = 0.128).To analysis the correlation between LVEF and Tei index, all the patients were divided into three groups, named before therapy, 6 months, 18 months. It showed that before therapy, p = 0.003, there were statistically significant difference; 6 months group, p = 0.001, there were statistically significant difference; 18 months group p = 0.002, there were statistically significant difference. To examined the correlation between Tei index and E/A ratio, the results showed that the before therapy group, p = 0.059, there were not statistically significant difference; 6 months group, p = 0.054, there were not statistically significant difference; 18 months group showed p = 0.053, there were not statistically significant difference.During 18 months follow-up, 4 sinus bradycardia occurred in patients. MACE appeared in 1 patient, which diagnosed as acute myocardial infarction(AMI). PCI underwent again with origin dose of bisoprolol maintaining. 2 patients with heart failure appeared at 6 months and the doctor reduce dosage. Both of them had not stopped application of bisoprolol. There were not recurrence of heart failure until 18 months, and they were getting better after treatment.Conclusion:1. long-term use of bisoprolol in patients with PCI can improve left ventricular systolic function. 2. Tei index and LVEF are negatively correlated; Tei index, as the indicator of cardiac function, is more sensitive than LVEF in the evaluation of left ventricular systolic function. 3. There is no clear correlation between Tei index and E/A value;The value of Tei index in the evaluation of left ventricular diastolic function has a limited role.