[Echocardiography-derived Tei index during surgery, a predictor of postoperative cardiovascular complications].
OBJECTIVE
The Tei index is a Doppler echocardiographic parameter that reflects both systolic and diastolic myocardial function. Our aim was to monitor the Tei index by transesophageal echocardiography during noncardiac surgery to explore the correlation between this parameter and the incidence of postoperative cardiovascular complications.


METHODS
Patients at risk of cardiovascular complications were enrolled. The Tei index was derived from the pattern of pulsed Doppler transmitral filling and aortic outflow, by dividing the sum of isovolumetric contraction and relaxation intervals by ejection time in milliseconds.


RESULTS
Seventy-three patients (58% men) were enrolled. The mean (SD) age was 68 (12) years. Two groups were identified based on myocardial function. A Tei index over 0.35 defined group 2 (n = 25) and correlated with a larger number of postoperative cardiovascular events. In patients with a normal Tei index less than 0.35 (group 1, n = 48), the incidence of cardiovascular complications was lower. Hypotension occurred in 60% of patients in group 2 and 21% of those in group 1, hypertension in 24% of group 2 and 4.1% of group 1, and pulmonary edema in 8% of group 2 and 2.1% of group 1 (P < .05 for all comparisons).


CONCLUSIONS
This pilot study found that patients with a high Tei index were more likely to develop postoperative cardiovascular complications. This index may provide a useful indicator to take into consideration in planning hemodynamic management when patients have a history of cardiovascular disease.
Cabrera Schulmeyer
M C
MC
Departamento de Anestesiología, Hospital Clínico Fuerza Aérea de Chile. carol218@vtr.net
Farías
J
J
De la Maza
J
J
Labbé
M
M
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D018619:Echocardiography, Doppler, Pulsed; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006976:Hypertension, Pulmonary / Q000150:complications; D007022:Hypotension / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010865:Pilot Projects; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D012306:Risk; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology