title: Doppler-derived myocardial performance index in patients with impaired left ventricular relaxation and preserved systolic function.
abstract: BACKGROUND
  The Doppler-derived myocardial performance index (MPI) has been used in the evaluation of left ventricular (LV) function in several diseases. In patients with isolated diastolic dysfunction, the diagnostic utility of this index remains unclear. The aim of this study was to determine the diagnostic utility of MPI in patients with systemic hypertension, impaired LV relaxation, and normal ejection fraction.
  
  
  METHODS
  Thirty hypertensive patients with impaired LV relaxation were compared to 30 control subjects. MPI and its components, isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), and the ejection time (ET), were measured from LV outflow and mitral inflow Doppler velocity profiles.
  
  
  RESULTS
  MPI was higher in patients than in control subjects (0.45 +/- 0.13 vs 0.37 +/- 0.07 P < 0.0029). The increase in MPI was due to the prolongation of IRT without significant change of ICT and ET. MPI cutoff value of > or =0.40 identified impaired LV relaxation with a sensitivity of 63% and specificity of 70% while an IRT >94 ms had a sensitivity of 67% and specificity of 80%. Multivariate analysis identified relative wall thickness, mitral early filling wave velocity (E), and systolic myocardial velocity (Sm) as independent predictors of MPI in patients with hypertension.
  
  
  CONCLUSIONS
  MPI was increase in patients with hypertension, diastolic dysfunction, and normal ejection fraction but was not superior to IRT to detect impaired LV relaxation.
authors.affiliation: Cardiology Division, Federal University of Alagoas, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: José Maria G
authors.initials: JM
authors.lastname: Fernandes
authors.forename: Ivan Romero
authors.initials: IR
authors.lastname: Rivera
authors.forename: Benício
authors.initials: B
authors.lastname: de Oliveira Romão
authors.forename: Maria Alayde
authors.initials: MA
authors.lastname: Mendonça
authors.forename: Miriam Lira Castro
authors.initials: ML
authors.lastname: Vasconcelos
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Carvalho
authors.forename: Orlando
authors.initials: O
authors.lastname: Campos
authors.forename: Angelo Amato V
authors.initials: AA
authors.lastname: De Paola
authors.forename: Valdir A
authors.initials: VA
authors.lastname: Moisés
mesh_terms: D000328:Adult; D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*