title: 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.
abstract: BACKGROUND
  Tei index obtained from tissue Doppler echocardiography (TDE-Tei index) has an inherent advantage of recording its systolic and diastolic components simultaneously on the same cardiac cycle. The aims of this study are to evaluate whether TDE-Tei index also exerts a correlation with left ventricular (LV) systolic and diastolic function and filling pressure and to see whether it can effectively identify the pseudonormal/restrictive mitral filling pattern.
  
  
  METHODS
  Echocardiographic examination was performed in 243 consecutive patients. These patients were classified into three groups as normal, abnormal relaxation, and pseudonormal/restrictive groups according to the transmitral E/A-wave velocity (E/A), early diastolic velocity of lateral mitral annulus (Ea) and E/Ea.
  
  
  RESULTS
  Standard Doppler indices of LV filling such as E, A, E/A, and E-wave deceleration time had a bimodal distribution, but Ea decreased and E/Ea and TDE-Tei index increased progressively with worsening of LV diastolic function. The sensitivity and specificity of TDE-Tei index>0.51 in the discrimination of pseudonormal/restrictive filling pattern were 85% and 96%, respectively. After stepwise multiple linear regression analysis, TDE-Tei index had a significant negative correlation with Ea (beta=-0.296, P<0.001) and ejection fraction (beta=-0.293, P<0.001) and positive correlation with E/Ea (beta=0.235, P=0.001).
  
  
  CONCLUSIONS
  TDE-Tei index increased with worsening of LV diastolic function and can effectively identify the pseudonormal/restrictive mitral inflow pattern. It also correlated with the echocardiographic parameters of LV systolic and diastolic function and filling pressure. It suggests that TDE-Tei index is a simple and feasible marker in assessing global LV function.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Lee
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Chu
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D019540:Area Under Curve; D003324:Coronary Artery Disease / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D003920:Diabetes Mellitus / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000502:physiology*; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*