Tei index obtained from Tissue Doppler Imaging: correlation with NTproBNP levels in patients with…

Tei index obtained from Tissue Doppler Imaging: correlation with NTproBNP levels in patients with…

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Article_Title: Tei index obtained from Tissue Doppler Imaging: correlation with NTproBNP levels in patients with dilated cardiomiopathy
Authors: Ioanna ZACHAROPOULOU*, Cristian MORNOŞ, Adina Ionac, Ştefan-Iosif DRĂGULESCU
Affiliation: “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
Abstract: The myocardial performance index (Tei index) determined by the pulsed Doppler is a simple and noninvasive measurement for assessing global left ventricular (LV) function. This index can also be obtained by tissue Doppler imaging (Tei-TDI). The purpose of our study was to assess the relationship between Tei-TDI and N-terminal pro-brain natriuretic peptide (NTproBNP) levels in patients with dilated cardiomyopathy (DCM). Conventional echocardiography and TDI were performed simultaneously with NTproBNP in 50 consecutive patients with DCM, in sinus rhythm. We demonstrated the best linear correlation between Tei-TDI and NTproBNP. The optimal Tei-TDI cut-off for prediction of NTproBNP levels >900 pg/ml was 0.66 (sensitivity of 73% and specificity of 71%). Tei-TDI had a good accuracy to predict high NTproBNP levels and could be used for the global echocardiographic estimation of the LV function in patients with DCM.
Keywords: Natriuretic Peptide, Myocardial Performance Index, Mitral Annulus Velocity, Tissue Doppler Imaging
References: J, Ingelsson E, Riserus U, et al: Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J 2004; 25:2220–2225.
Arques S, Roux E, Luccioni R. Current clinical applications of spectral tissue Doppler echocardiography (E/E′ ratio) as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function. Cardiovasc Ultrasound 2007; 5:16.
Ascione L, Michele MD, Accadia M, et al: Myocardial global performance index as a predictor of in-hospital cardiac events in patients with first myocardial infarction. J Am Soc Echocardiogr 2003; 6:1019–1023.
Barnes SC, Collinson PO, Galasko G et al. Evaluation of N-terminal pro-B type natriuretic peptide analysis on the Elecsys 1010 and 2010 analysers. Ann Clin Biochem 2004; 41(6):459–463.
Bruch C, Grude M, Muller J, Breithardt G, Wichter T: Usefulness of tissue Doppler imaging for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure. Am J Cardiol 2005; 95:892-895.
Burke M, Cotts W. Interpretation of B-type natriuretic peptide in cardiac disease and other comorbid conditions. Heart Fail Rev 2007; 12 (1):23-36.
Ceyhan C, Unal S, Yenisey EC et al. The role of N terminal pro-brain natriuretic peptide in the evaluation of left ventricular diastolic dysfunction: correlation with echocardiographic indexes in hypertensive patients. Int J Cardiovasc Imaging 2008; 24(3):253-9.
De Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet 2003; 362 (9380):316–322.
Dokainish H. Tissue Doppler imaging in the evaluation of ventricular diastolic function. Curr Opin Cardiol 2004; 19:437-441.
Dujardin KS, Tei C, Yeo TC, et al: Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 1998; 82:1071–1076.
Elnoamany MF, Abdelhameed AK. Mitral annular motion as a surrogate for left ventricular function: Correlation with brain natriuretic peptide levels. Eur J Echocardiography 2006; 7:187-198.
Felker GM, Petersen JW, Mark DB. Natriuretic peptides in the diagnosis and management of heart failure. CMAJ 2006;175 (6): 611-617.
Gottdiener JS, Bednarz J, Devereux R. American Society of Echocardiography. American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 2004; 17:1086-1119
Hadano Y, Murata K, Liu J, et al. Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure? Circ J 2005; 69:432-438.
Hall C. Essential biochemistry and physiology of (NT-pro)BNP. Eur J Heart Fail 2004;6 (3):257–260
Henry WL, Gardin JM, Ware JH. Echocardiographic measurements in normal subjects from infancy to old age. Circulation. 1980;62:1054-1061.
Kazanegra R, Cheng V, Garcia A et al. A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study. J Card Fail 2001; 7 (1):21–29.
Lang RM, Bierig M, Devereux RB et al. Recommendations for chamber quantification. Eur J Echocardiography 2006; 7 (2):79-108.
Maeda K, Tsutamoto T, Atsuyuki W et al. Plasma BNP as a biochemical marker of high LVEDP in patients with symptomatic left ventricular dysfunction. Am Heart J 1998;135 ( 5 Pt 1): 825–832.
Mottram PM, Leano R, Marwick TH. Usefulness of B-type natriuretic peptide in hypertensive patients with exertional dyspnea and normal left ventricular ejection fraction and correlation with new echocardiographic indexes of systolic and diastolic function. Am J Cardiol 2003; 92(12):1434–1438.
Richardson P, McKenna W, Bristow M et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 1996; 93:841–842.
Su HM, Lin TH, Voon WC, et al. Differentiation of left ventricular diastolic dysfunction, identification of pseudonormal/restrictive mitral inflow pattern and determination of left ventricular filling pressure by Tei index obtained from tissue Doppler echocardiography. Echocardiography. 2006; 23(4):287-94.
Tei C, Ling LH, Hodge DO et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function: a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366
Tei C, Nishimura RA, Seward JB, et al: Noninvasive Doppler-derived myocardial performance index: Correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 1997; 10:169–178.
Thiene G, Corrado D, Basso C. Revisiting definition and classification of cardiomyopathies in the era of molecular medicine. Eur. Heart J., 2008; 29(2): 144 – 146.
Tretjak M, Verovnik F, Benko D, Kozel M. Tissue Doppler velocities of mitral annulus and NT-proBNP in patients with heart failure. Eur J Heart Fail 2005; 7 (4): 520– 524.
Maron BJ, Towbin JA, Thiene G et al. Contemporary Definitions and Classification of the Cardiomyopathies An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006;113:1807-1816.
Nagueh SF, Middleton KJ, Kopelen HA, et al. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 1997;30:1527–1533.
Oki T, Tabata T, Yamada HL et al. Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. Am J Cardiol 1997; (7) 79:921–928.
Ommen S, Nishimura RA, Appleton CP, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 2000; 102:1788–1794.
Poulsen SH, Jensen SE, Tei C, et al: Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction. J Am Soc Echocardiogr 2000;13:723–730.
Quinones MA, Otto CM, Stoddard M et al. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002; 15 (2):167–184.
Wang J, Khoury DS, Thohan V et al. Global Diastolic Strain Rate for the Assessment of Left Ventricular Relaxation and Filling Pressures. Circulation 2007; 115(11):1376-1383.
Read_full_article: pdf/20-2010/20-1-2010/SU20-1-10Zacharopoulou.pdf
Correspondence: Ioanna Zacharopoulou, MD, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania, E-mail: mornoscristi@yahoo.com

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Article Title: Tei index obtained from Tissue Doppler Imaging: correlation with NTproBNP levels in patients with dilated cardiomiopathy
Authors: Ioanna ZACHAROPOULOU*, Cristian MORNOŞ, Adina Ionac, Ştefan-Iosif DRĂGULESCU
Affiliation: “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
Abstract: The myocardial performance index (Tei index) determined by the pulsed Doppler is a simple and noninvasive measurement for assessing global left ventricular (LV) function. This index can also be obtained by tissue Doppler imaging (Tei-TDI). The purpose of our study was to assess the relationship between Tei-TDI and N-terminal pro-brain natriuretic peptide (NTproBNP) levels in patients with dilated cardiomyopathy (DCM). Conventional echocardiography and TDI were performed simultaneously with NTproBNP in 50 consecutive patients with DCM, in sinus rhythm. We demonstrated the best linear correlation between Tei-TDI and NTproBNP. The optimal Tei-TDI cut-off for prediction of NTproBNP levels >900 pg/ml was 0.66 (sensitivity of 73% and specificity of 71%). Tei-TDI had a good accuracy to predict high NTproBNP levels and could be used for the global echocardiographic estimation of the LV function in patients with DCM.
Keywords: Natriuretic Peptide, Myocardial Performance Index, Mitral Annulus Velocity, Tissue Doppler Imaging
References: J, Ingelsson E, Riserus U, et al: Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J 2004; 25:2220–2225.
Arques S, Roux E, Luccioni R. Current clinical applications of spectral tissue Doppler echocardiography (E/E′ ratio) as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function. Cardiovasc Ultrasound 2007; 5:16.
Ascione L, Michele MD, Accadia M, et al: Myocardial global performance index as a predictor of in-hospital cardiac events in patients with first myocardial infarction. J Am Soc Echocardiogr 2003; 6:1019–1023.
Barnes SC, Collinson PO, Galasko G et al. Evaluation of N-terminal pro-B type natriuretic peptide analysis on the Elecsys 1010 and 2010 analysers. Ann Clin Biochem 2004; 41(6):459–463.
Bruch C, Grude M, Muller J, Breithardt G, Wichter T: Usefulness of tissue Doppler imaging for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure. Am J Cardiol 2005; 95:892-895.
Burke M, Cotts W. Interpretation of B-type natriuretic peptide in cardiac disease and other comorbid conditions. Heart Fail Rev 2007; 12 (1):23-36.
Ceyhan C, Unal S, Yenisey EC et al. The role of N terminal pro-brain natriuretic peptide in the evaluation of left ventricular diastolic dysfunction: correlation with echocardiographic indexes in hypertensive patients. Int J Cardiovasc Imaging 2008; 24(3):253-9.
De Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet 2003; 362 (9380):316–322.
Dokainish H. Tissue Doppler imaging in the evaluation of ventricular diastolic function. Curr Opin Cardiol 2004; 19:437-441.
Dujardin KS, Tei C, Yeo TC, et al: Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 1998; 82:1071–1076.
Elnoamany MF, Abdelhameed AK. Mitral annular motion as a surrogate for left ventricular function: Correlation with brain natriuretic peptide levels. Eur J Echocardiography 2006; 7:187-198.
Felker GM, Petersen JW, Mark DB. Natriuretic peptides in the diagnosis and management of heart failure. CMAJ 2006;175 (6): 611-617.
Gottdiener JS, Bednarz J, Devereux R. American Society of Echocardiography. American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 2004; 17:1086-1119
Hadano Y, Murata K, Liu J, et al. Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure? Circ J 2005; 69:432-438.
Hall C. Essential biochemistry and physiology of (NT-pro)BNP. Eur J Heart Fail 2004;6 (3):257–260
Henry WL, Gardin JM, Ware JH. Echocardiographic measurements in normal subjects from infancy to old age. Circulation. 1980;62:1054-1061.
Kazanegra R, Cheng V, Garcia A et al. A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study. J Card Fail 2001; 7 (1):21–29.
Lang RM, Bierig M, Devereux RB et al. Recommendations for chamber quantification. Eur J Echocardiography 2006; 7 (2):79-108.
Maeda K, Tsutamoto T, Atsuyuki W et al. Plasma BNP as a biochemical marker of high LVEDP in patients with symptomatic left ventricular dysfunction. Am Heart J 1998;135 ( 5 Pt 1): 825–832.
Mottram PM, Leano R, Marwick TH. Usefulness of B-type natriuretic peptide in hypertensive patients with exertional dyspnea and normal left ventricular ejection fraction and correlation with new echocardiographic indexes of systolic and diastolic function. Am J Cardiol 2003; 92(12):1434–1438.
Richardson P, McKenna W, Bristow M et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 1996; 93:841–842.
Su HM, Lin TH, Voon WC, et al. Differentiation of left ventricular diastolic dysfunction, identification of pseudonormal/restrictive mitral inflow pattern and determination of left ventricular filling pressure by Tei index obtained from tissue Doppler echocardiography. Echocardiography. 2006; 23(4):287-94.
Tei C, Ling LH, Hodge DO et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function: a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366
Tei C, Nishimura RA, Seward JB, et al: Noninvasive Doppler-derived myocardial performance index: Correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 1997; 10:169–178.
Thiene G, Corrado D, Basso C. Revisiting definition and classification of cardiomyopathies in the era of molecular medicine. Eur. Heart J., 2008; 29(2): 144 – 146.
Tretjak M, Verovnik F, Benko D, Kozel M. Tissue Doppler velocities of mitral annulus and NT-proBNP in patients with heart failure. Eur J Heart Fail 2005; 7 (4): 520– 524.
Maron BJ, Towbin JA, Thiene G et al. Contemporary Definitions and Classification of the Cardiomyopathies An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006;113:1807-1816.
Nagueh SF, Middleton KJ, Kopelen HA, et al. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 1997;30:1527–1533.
Oki T, Tabata T, Yamada HL et al. Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. Am J Cardiol 1997; (7) 79:921–928.
Ommen S, Nishimura RA, Appleton CP, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 2000; 102:1788–1794.
Poulsen SH, Jensen SE, Tei C, et al: Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction. J Am Soc Echocardiogr 2000;13:723–730.
Quinones MA, Otto CM, Stoddard M et al. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002; 15 (2):167–184.
Wang J, Khoury DS, Thohan V et al. Global Diastolic Strain Rate for the Assessment of Left Ventricular Relaxation and Filling Pressures. Circulation 2007; 115(11):1376-1383.
*Correspondence: Ioanna Zacharopoulou, MD, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania, E-mail: mornoscristi@yahoo.com