Doppler-derived myocardial performance index in patients with impaired left ventricular relaxation and preserved systolic function.
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.
Fernandes
José Maria G
JM
Cardiology Division, Federal University of Alagoas, Federal University of Sao Paulo, Sao Paulo, Brazil.
Rivera
Ivan Romero
IR
de Oliveira Romão
Benício
B
Mendonça
Maria Alayde
MA
Vasconcelos
Miriam Lira Castro
ML
Carvalho
Antônio Carlos
AC
Campos
Orlando
O
De Paola
Angelo Amato V
AA
Moisés
Valdir A
VA
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*