Journal of the American Society of Echocardiography
Original articleLeft Ventricle Myocardial Performance Index Derived Either By Conventional Method or Mitral Annulus Tissue-Doppler: A Comparison Study in Healthy Subjects and Subjects with Heart Failure
Section snippets
Study Population
Group A consisted of 70 consecutive healthy adults who were studied on the basis of the following inclusion criteria: age between 20 and 55 years, normal sinus rhythm, normal blood pressure, left ventricular ejection fraction (LVEF) greater than 50% and otherwise normal echocardiogram with normal diastolic transmitral PW-Doppler pattern, normal diastole at PW-TD, and absence of any known cardiac or noncardiac disease. Exclusion criteria were inadequate visualization and presence of bundle
Results
Patient demographics, LVEF, Doppler, tissue Doppler parameters, and MPI in the study groups are reported in Table 1. Figure 3 graphically shows MPI values obtained using both methods for both study groups. MPI measured by PW-TD was significantly higher (P < .0001) than MPI measured conventionally with PWD MPI both in group A (0.42 ± 0.09 vs 0.33 ± 0.09) and group B (0.79 ± 0.12 vs 0.69 ± 0.15). These results were driven by longer “a1” intervals compared with “a” intervals in the same group;
Discussion
Both PWD and PW-TD MPI have very high sensitivity and specificity to differentiate between healthy subjects and patients affected by CHF with mild to moderate reduction of systolic function.
Mild agreement was found between the conventional PWD and the new PW-TD method for MPI calculation when used in a single subject, but optimal cutoff values to diagnose CHF were different, 0.50 and 0.60, respectively.
Conclusion
This study supports the use of a different, higher MPI cut-point for best diagnostic accuracy when using the new PW-TD method compared with the conventional one.
The present study suggests that PW-TD MPI is an excellent alternative to conventional MPI; PW-TD MPI may be particularly useful when PWD intervals are technically difficult to measure or a high beat-to-beat heart rate variability may impair MPI calculation with conventional PWD.
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