Impact of preload alterations by haemodialysis on the Tei index: comparison between pulsed flow and tissue Doppler analyses.
OBJECTIVE
The aim of this study is to evaluate and compare the impact of preload alterations by haemodialysis (HD) on the Tei index obtained by pulsed Doppler echocardiography (PDE-Tei index) and tissue Doppler echocardiography (TDE-Tei index).


RESULTS
Thirty-eight uraemic patients underwent echocardiography 1 hour before and 1 hour after HD was studied. Before HD, PDE- and TDE-Tei indices had a weak correlation (r = 0.439, P = 0.006). After HD, the correlation became stronger (r = 0.794, P < 0.001). After HD, body weight (P < 0.001), early transmitral filling wave peak velocity (E) (P < 0.00 1), early diastolic mitral annular velocity (Em) (P < 0.00 1), and E/Em (P = 0.00 1) decreased and PDE- (P < 0.00 1) and TDE-Tei indices (P = 0.022) increased significantly. In addition, after HD, body weight reduction had a significant correlation with E decrease and PDE- and TDE-Tei index increase (P < 0.00 1, P = 0.005, and P = 0.016, respectively). A subgroup comparison showed that in patients with body weight reduction < 3 kg, the PDE-Tei index (P = 0.003) increased significantly but TDE-Tei index (P = 0.209) did not change after HD. In patients with body weight reduction > or = 3 kg, both the PDE- and TDE-Tei indices (P = 0.003 and 0.042, respectively) increased significantly after HD.


CONCLUSIONS
Both the PDE- and TDE-Tei indices are preload-dependent indicators. However, TDE-Tei index is less preload-dependent and is more accurate in assessing global left ventricular function in patients with body weight reduction < 3 kg after HD.
Su
Ho-Ming
HM
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung, Taiwan.
Lin
Tsung-Hsien
TH
Voon
Wen-Chol
WC
Chen
Hung-Chun
HC
Lin
Feng-Hsien
FH
Kuo
Mei-Chuan
MC
Lee
Kun-Tai
KT
Chu
Chih-Sheng
CS
Lai
Wen-Ter
WT
Sheu
Sheng-Hsiung
SH
D003935:Diagnostic Techniques, Cardiovascular; D003971:Diastole; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve; D011379:Prognosis; D011674:Pulse; D006435:Renal Dialysis; D013318:Stroke Volume; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014511:Uremia / Q000000981:diagnostic imaging; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*