Effect of preload and heart rate on the doppler and tissue doppler-derived myocardial performance index.
Doppler-derived myocardial performance index (MPI) has been described as a noninvasive measurement of LV function. Our aim was to investigate the effect of hemodialysis related volume reduction and heart rate changes on the Doppler-derived LV MPI, and Doppler tissue imaging (DTI) derived left and right ventricular MPI.


METHODS
The study group comprised 32 consecutive patients (mean age: 43 +/- 18 yrs) undergoing hemodialysis. Patients underwent echocardiography before and immediately after hemodialysis session. Left and right ventricular MPI derived from conventional pulsed-wave Doppler and DTI was calculated. The difference in MPI, heart rate and body weight was calculated before and after hemodialysis.


RESULTS
Doppler-derived LV MPI, and right ventricular MPI obtained by DTI were increased (p = 0.05) but the LV MPI obtained by DTI was unchanged after hemodialysis. There is a significant positive correlation between the Doppler-derived LV MPI difference and volume reduction (r = 0.38, p = 0.032). The heart rate difference was correlated with Doppler-derived LV MPI difference, and DTI derived right ventricular MPI difference (r = 0.38, p = 0.034; r = 0.48, p = 0.006, respectively). Whereas, DTI derived LV MPI difference was not correlated with heart rate difference. By the multivariate analysis, there was no correlation between Doppler-derived LV MPI difference with heart rate difference, and volume reduction. Right ventricular MPI difference correlated with heart rate difference (r = 0.41, p = 0.021) but not with volume reduction. Doppler-derived MPI is partially influenced by preload and heart rate changes. However, DTI derived LV MPI is not influenced by preload and heart rate changes.
Ozdemir
Kurtuluş
K
Selcuk University, Meram School of Medicine, Department of Cardiology, Konya, Turkey. kurt33@hotmail.com
Balci
Sibel
S
Duzenli
Mehmet Akif
MA
Can
Ilknur
I
Yazici
Mehmet
M
Aygul
Nazif
N
Altunkeser
Bulent Behlul
BB
Altintepe
Lutfullah
L
Turk
Suleyman
S
D000328:Adult; D001021:Aortic Valve; D001794:Blood Pressure; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008943:Mitral Valve; D009200:Myocardial Contraction / Q000502:physiology*; D011379:Prognosis; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole