Long-term prognostic value of an index of myocardial performance in patients with myocardial infarction.
BACKGROUND
The Tei index of myocardial performance (IMP), which combines parameters of both systolic and diastolic ventricular function, is a useful prognostic factor in many clinical settings.


OBJECTIVE
This study assessed the long-term prognostic value of IMP in patients discharged from hospital after acute myocardial infarction (AMI).


METHODS
Doppler/echocardiographic studies were recorded in 90 consecutive patients on Day 14 +/- 2 following an AMI. The IMP was calculated from the Doppler recordings, as a sum of isovolumetric contraction time and isovolumetric relaxation time, divided by the ejection time.


RESULTS
The patients were followed for an average (SD) of 57.8 (16.1) months. During this period there were 22 (24%) cardiac events, defined as cardiac deaths (10) or nonfatal recurrent myocardial infarctions (12). After multivariate Cox analysis, Tei index > 0.55 (relative risk [RR] 4.45; 95% confidence interval [CI] 1.28-15.45; p = 0.019), LV end-systolic volume > 65 ml (RR 3.23; 95% CI 1.34-7.79; p = 0.009), and mitral E wave deceleration time < or = 0.145 s (RR 2.94; 95% CI 1.24-6.92; p = 0.014) were the only independent predictors of cardiac events during the follow-up period. In a subgroup of patients with preserved LV systolic function (ejection fraction > 0.40), IMP was the only predictor of cardiac events (RR 6.37; 95% CI 1.32-30.77, p = 0.02).


CONCLUSIONS
The Tei index of myocardial performance, which is simple and easy to calculate, is a useful tool for risk assessment in patients following myocardial infarction, and in a subgroup of patients with normal or only mildly impaired systolic function.
Szymański
Piotr
P
Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland. piotr.szymanski@mediclub.pl
Rezler
Joanna
J
Stec
Sebastian
S
Budaj
Andrzej
A
D000368:Aged; D018572:Disease-Free Survival; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D013997:Time Factors