Feasibility Study On Evaluating Right Ventricular Diastolic Function By New Tei'-Index

ObjectiveDoppler-derived myocardial performance index(Tei)has been used in the evaluation of right ventricular(RV)function in several diseases.In patients with isolated diastolic dysfunction,the diagnostic utility of this index remains controversial.Right ventricular(RV)-Tei index,also called RV cardiac performance index is well accepted as a decent index to describe cardiac function.However,this index becomes inconclusive when dealing with isolated diastolic dysfunction.Suggested by the new vision of symmetry of cardiac function assessment,we modified RV-Tei index to RV-Tei' index to better describe diastolic function.We sought to find a new Tei' index that is more appropriate for evaluating RV diastolic function.The purpose of this study is to demonstrate the diagnostic value of this new index in patients with RV isolated diastolic dysfunction(IDD).Methods21 patients with impaired RV relaxation were compared to 44 control subjects.Isovolumetric relaxation time(IRT),isovolumetric contraction time(ICT),the ejection time(ET),and RV rapid filling time(RFT)were measured from RV outflow and tricuspid inflow Doppler velocity profiles.RV-Tei is calculated as(ICT+IRT)/ET and RV-Tei' is calculated as(ICT+IRT)/RFP.ResultsRV-Tei index is inconclusive in comparison of IDD group and control subjects(0.21 ± 0.08 vs 0.23 ± 0.07 P=NS).In the meantime,the RV-Tei' index is significantly decreased in IDD group when compared with the control group(0.24±0.09 vs 0.32±0.12,p<0.05).We also found that the RV-Tei' index correlates well with other doppler measurements of diastolic parameters like E/A(r=-0.081,P<0.05),E/E'(r=-0.016,P<0.05),DT(r=-1.011,P < 0.01),which suggests its potential use as a noninvasive indicator of the right ventricular(RV)relaxation.Moreover,RV-Tei' index cutoff of ?0.31 identified impaired RV relaxation with a sensitivity of 50% and specificity of 84%.conclusionThe modified RV-Tei ' index is an effective indicator that can be used to detect right ventricular IDD instead of classical RV-Tei.