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.
Selcuk University, Meram School of Medicine, Department of Cardiology, Konya, Turkey. kurt33@hotmail.com
Kurtuluş
K
Ozdemir
Sibel
S
Balci
Mehmet Akif
MA
Duzenli
Ilknur
I
Can
Mehmet
M
Yazici
Nazif
N
Aygul
Bulent Behlul
BB
Altunkeser
Lutfullah
L
Altintepe
Suleyman
S
Turk
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