title: Left 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.
abstract: OBJECTIVE
  The aims of this study were to investigate the clinical agreement between myocardial performance index (MPI) measured conventionally and by pulsed-wave tissue Doppler (PW-TD) of the mitral annulus, and to test whether PW-TD MPI can accurately differentiate between healthy subjects and patients affected by congestive heart failure (CHF) with mild to moderate reduction of systolic function.
  
  
  BACKGROUND
  Calculation of MPI using PW-TD may have advantages over conventional left ventricle inflow/outflow tract pulsed-wave Doppler (PWD) method; for example, all of the data needed for PW-TD MPI calculation can be derived from one single cardiac cycle, whereas with PWD at least two different cycles are needed. Thus, heart rate variability does not interfere with PW-TD MPI.
  
  
  RESULTS
  In group A, we included 70 healthy adults with normal left ventricular ejection fraction and normal diastole, whereas for group B we studied 50 patients with CHF and left ventricular ejection fraction between 35% and 45%. MPI measured with PWD was statistically different (P < .0001) from MPI measured with PW-TD both in group A (0.33 +/- 0.09 vs 0.42 +/- 0.09) and group B (0.69 +/- 0.15 vs 0.79 +/- 0.12). Nonetheless, clinical agreement existed between the two methods in the single subject. Receiver operating characteristic curves showed very high accuracy for both methods to discriminate patients with CHF from healthy subjects; the optimal cutoff point was different and specific to each method: 0.50 for the conventional method and 0.60 for the PW-TD method.
  
  
  CONCLUSIONS
  We found clinical agreement between MPI measured in the same subject with the conventional PWD method and with PW-TD. Both methods had similarly high diagnostic accuracy for CHF, but this study supports the use of a higher MPI cut-point for best diagnostic accuracy when using the new PW-TD method.
  
  
  CONCLUSIONS
  We performed a study in healthy adults and in patients with congestive heart failure to investigate the clinical agreement between MPI measured conventionally and by PW-TD of the mitral annulus. We found mild agreement between MPI measured by the conventional method and by PW-TD. Both methods had high diagnostic accuracy for CHF. PW-TD method requires a higher MPI cut-point for best diagnostic accuracy.
authors.affiliation: Department of Cardiology, Ospedale Civile, Desenzano del Garda (BS), Italy. nicola.gaibazzi@inwind.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Gaibazzi
authors.forename: Nicola
authors.initials: N
authors.lastname: Petrucci
authors.forename: Vigilio
authors.initials: V
authors.lastname: Ziacchi
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D012098:Reproduction; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology