Usefulness of Tissue Doppler
Imaging-Myocardial Performance Index
in the Evaluation of Diastolic Dysfunction
and Heart Failure With Preserved Ejection
- Affiliated Author(s)
- 김형섭; 윤혁준; 박형섭; 조윤경; 남창욱; 허승호; 김윤년; 김권배
- Alternative Author(s)
- Kim, Hyung Seop; Yoon, Hyuck Jun; Park, Hyoung Seob; Cho, Yun Kyeong; Nam, Chang Wook; Hur, Seung Ho; Kim, Yoon Nyun; Kim, Kwon Bae
- Journal Title
- Clinical Cardiology
- Issued Date
- Background: In heart failure with preserved ejection fraction (HFPEF), physiological abnormalities are not solely
restricted to diastolic function. Because the tissue Doppler imaging (TDI)-derived myocardial performance
index (MPI) offers the advantage of recording systolic and diastolic tissue velocity simultaneously in the same
cardiac cycle, this study aimed to determine whether TDI-MPI is an informative index for assessing HFPEF,
compared with conventional echo parameters.
Hypothesis: In patients with HFPEF, TDI-MPI would be an independent predictor for adverse cardiac events.
Methods: Among 408 patients who had diastolic dysfunction without heart failure (HF) or HFPEF, cardiac
function was evaluated by mitral flow (MF) or TDI-MPI. During the median follow-up of 32 months, clinical
outcomes, which were defined as the composite of cardiovascular death and admission for HF, were assessed.
Results: Mean MF and TDI-MPI were significantly greater in the HFPEF group. TDI-MPI rather than MF had a
significant correlation with N-terminal pro-brain natriuretic peptide level. The area under the receiver operating
characteristic curve of TDI-MPI for the detection of HFPEF was 0.86. With regard to clinical outcomes, 31 events
were identified during follow-up periods. On a multivariate analysis, TDI-MPI >0.66 was the best prognostic
predictor of events and provided incremental predictive value.
Conclusions: Compared to MF-MPI, TDI-MPI may be a more useful parameter for the evaluation of patients
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