| Aims With the increasing incidence of myocardial infarction and post-infarction heart failure, the evaluation of cardiac function is becoming more important. Though former research usually focused on the systolic function or systolic and diastolic function seperately , systolic and diastolic disfunction often appear simultaneously. So cardiac function should be estimate as a whole to guide the clinic treatment and estimate the prognosis. Echocardiography is one of the safest and most convenient methods to access cardiac function, but it has some shortcoming in the condition of post ventricular reconstitution and deformation caused by myocardial necrosis. This research is trying to evaluate the changes of cardiac function in patients with AMI before and after PCI by the rutineechocardiography (LVEF, E/A etc. ) and Tei index. Tei index is a recentlyappeared index of echocardiography which can integratedly evaluate systolic and diastolic function and without the affect of the morphous, heart rate and blood pressure.Methods Echocardiogrphy were performed in 74 patients with AMI (MI group) and 24 non-AMI patients (control group). From parasternal long axis, LVDd and LVDs were measure by M-mode;From apex four chanmber view, EDV and ESV were measure by simplified Simpson method, LVEF was calculated, and by the pulse doppler of mitral and aortic valves, mitral valve diasolic flow E wave, A wave, ICT, IRT,and ET were measured. Tei index was calculated by the formula (ICT+IRT)/ET. Transmitral propagation velocity (Vp) was measued by colorM-mode. AMI patients were dived to killip grade I (without heart failure) andkillip grade II—IV (without heart failure) . All the AMI patients accepte coronaryangiography, in 61 of which PCI were suscessfully performed, echocardiography were repeated 3-5 days after.Results LVEF^ Vp and Tei index in patients with AMI obviously difference with the controls, P<0.01;Tei index is well related with LVEF and Vp, r=-0.52,-0.41 P<0.01;85% of AMI patients have Tei index abnormality (>0.47), only 47% hasLVEF decrease (<0.5) , in 89% Vp<45cm/s;Tei index in killipII-IV patients werehigher than killip I (P<0.01) , Tei index >0.47 in all killip II-IV patients. Thesensitivity, specificity, positive predictive value and negative predictive value of Tei index >0.47 to predict post-MI heart failure are 63. 6%, 72. 9%^ 93. 4%-^ 25. 8%. Coronary angiography suggests the AMI patients of two vessel disease averagely, Tei index in patients with severe stenosis (>90%) are higher than that with moderate (<90%, >75%) and mild (<75%) stenosis (PO.01). In 61 sussessfully PCI-ed patients, IRT, Tei index and Vp are improved after PCI (P<0.01). LVEF are also imroved, but have not show any difference. Tei index of anterior wall AMI patients is higher than that with inferior wall AMIpatients(P<0.01) .Conclusions 1 .LVEF is lower, Vp is slower, Tei index is higher in patients withAMI . 2. Tei index in AMI patients is well related to LVEF and Vp. Tei index in patients with anterior wall AMI is higher than that with inferior wall AMI. 3.The sensitivity, specificity, positive predictive value and negative predictive value of Tei index predict heart failure are 63. 6%, 72. 9%, 93. 4%% 25. 8%. 4. Tei index is higher in severe stenosis patients than that with moderate and mild stenosis patients. 5. Tei index decreased and Vp increased after PCI.
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