title: A Doppler-derived index of combined left ventricular systolic and diastolic function is an independent predictor of cardiovascular mortality in elderly men.
abstract: BACKGROUND
  Few studies on echocardiographic and Doppler indices of cardiac function as predictors for cardiovascular mortality have been performed in the general population. The novel myocardial performance index (MPI, also denoted as Tei-Doppler index) has been suggested to reflect both left ventricular (LV) systolic and diastolic function.
  
  
  METHODS
  We investigated whether 10 different echocardiographic and Doppler indices of cardiac function predicted cardiovascular mortality by using a population-based cohort of 583 seventy-year-old men with a mean follow-up time of 6.8 years.
  
  
  RESULTS
  In a multivariate Cox proportional hazard analysis for a 1-SD increase including LV ejection fraction, E/A ratio, MPI, and traditional cardiovascular risk factors (previous myocardial infarction, hyperlipidemia, hypertension, diabetes, smoking status, and LV hypertrophy), both ejection fraction (hazard ratio [HR] = 0.59, 95% CI 0.38-0.90, P < .05) and MPI (HR = 2.92, 95% CI 1.71-4.97, P < .0001) were found to be independent predictors for cardiovascular mortality. After excluding subjects with coronary heart disease, only MPI remained a significant predictor (HR = 2.18, 95% CI 1.11-4.27, P < .03, for 1-SD increase), and neither ejection fraction, E/A ratio, nor any of the cardiovascular risk factors remained significant predictors.
  
  
  CONCLUSIONS
  Myocardial performance index is a predictor for cardiovascular mortality, independent of other measurements of cardiac function and of traditional cardiovascular risk factors in elderly men free from coronary heart disease.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Johan.Arnlov@pubcare.uu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Arnlöv
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
authors.forename: Bertil
authors.initials: B
authors.lastname: Andrén
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.forename: Lars
authors.initials: L
authors.lastname: Berglund
authors.forename: Hans
authors.initials: H
authors.lastname: Lithell
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*