HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 290/5/H1952    most recent 01090.2005v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (17) Citing Articles via Google Scholar Google Scholar Articles by Cannesson, M. Articles by Gorcsan, J. Search for Related Content PubMed PubMed Citation Articles by Cannesson, M. Articles by Gorcsan, J., III

Effects of modulation of left ventricular contractile state and loading conditions on tissue Doppler myocardial performance index

¹Cardiovascular Institute and ²Department of Critical Care Medicine, The University of Pittsburgh, Pittsburgh, Pennsylvania

Submitted 14 October 2005 ; accepted in final form 12 December 2005

The Tei index is clinically useful to quantify left ventricular (LV) function, but it requires sequential Doppler recordings from two different views. A related myocardial performance index (MPI) using tissue Doppler (TD) can be rapidly calculated from a single beat; however, its ability to quantify contractility and the effects of acute changes in loading have not been determined. Our aim was to test the hypothesis that TD MPI can quantify contractile state but is affected by acute alterations in loading, using LV pressure-volume relations in an animal model. Eight dogs were studied by using mitral annular TD, high-fidelity pressure, and conductance catheters. TD MPI was calculated as (a' – b')/b', where a' was the duration of mitral annular velocity during diastole and b' was the duration of the systolic wave. End-systolic elastance (E_es), the time constant of isovolumic relaxation (), and peak positive and negative first derivative of pressure (dP/dt_max and dP/dt_min, respectively) were used as measures of LV function. Data were obtained at baseline, at dobutamine and esmolol infusion to alter contractile state, and at inferior vena cava and aortic occlusion to alter preload and afterload. TD MPI decreased from 0.83 (SD 0.19) to 0.62 (SD 0.20) with dobutamine and increased to 1.19 (SD 0.26) with esmolol. TD MPI significantly correlated with dP/dt_max (r = –0.76), E_es (r = –0.68), dP/dt_min (r = 0.82), and (r = 0.78); however, it was affected by acute decreases in preload [from 0.83 (SD 0.19) to 1.09 (SD 0.36)] and acute increases in afterload [to 1.23 (SD 0.17)]. All the above increases and decreases and r values were significant (P < 0.05 vs. baseline). In conclusion, TD MPI can rapidly quantify alterations in LV contractile state but is affected by acute alterations in preload and afterload.

contractility; echocardiography; ventricles

This article has been cited by other articles:

				N. Mabrouk-Zerguini, P. Leger, S. Aubert, R. Ray, P. Leprince, B. Riou, P. Coriat, and A. Ouattara Tei index to assess perioperative left ventricular systolic function in patients undergoing mitral valve repair Br. J. Anaesth., October 1, 2008; 101(4): 479 - 485. [Abstract] [Full Text] [PDF]

				B. Leonardi, R. Margossian, S. D. Colan, and A. J. Powell Relationship of magnetic resonance imaging estimation of myocardial iron to left ventricular systolic and diastolic function in thalassemia. J. Am. Coll. Cardiol. Img., September 1, 2008; 1(5): 572 - 578. [Abstract] [Full Text] [PDF]

				G. Acharya, J. Rasanen, K. Makikallio, T. Erkinaro, T. Kavasmaa, M. Haapsamo, L. Mertens, and J. C. Huhta Metabolic acidosis decreases fetal myocardial isovolumic velocities in a chronic sheep model of increased placental vascular resistance Am J Physiol Heart Circ Physiol, January 1, 2008; 294(1): H498 - H504. [Abstract] [Full Text] [PDF]

				Y. Hori, T. Kano, F. Hoshi, and S.-i. Higuchi Relationship between tissue Doppler-derived RV systolic function and invasive hemodynamic measurements Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H120 - H125. [Abstract] [Full Text] [PDF]