title: Measurement of the myocardial performance index in ambulatory patients with heart failure: correlation with other clinical and echocardiographic parameters and independent prognostic value.
abstract: BACKGROUND
  Many echocardiographic parameters have been proposed for the assessment of the patients with heart failure (HF). Recently, the myocardial performance index (MPI) has been shown to be an accurate index of myocardial function. We assessed the correlation with other clinical and echocardiographic measurements and the prognostic value of MPI in patients with HF.
  
  
  RESULTS
  The MPI was assessed in 112 consecutive patients with persistent symptoms of HF (II-III NYHA class), sinus rhythm, LV systolic dysfunction (defined by an ejection fraction <or= 45%). At multivariable analysis, only NYHA class and ejection fraction were independently related to MPI. The severity of mitral regurgitation and MPI were the only parameters independently related to the incidence of death or cardiovascular hospitalizations. A MPI > 0.55 (median value) and medium to severe mitral regurgitation were associated with a relative risk of cardiovascular events of 18.7 (95% confidence interval [CI], 16.6-20.7; P < 0.005) and of 3.03 (95% CI, 2-4.1; P = 0.035), respectively.
  
  
  CONCLUSIONS
  In our patients with HF, MPI was the best predictor of cardiovascular events. Mitral regurgitation was the only other variable which had an additive prognostic value at multivariate analysis.
authors.affiliation: Department of Experimental and Applied Medicine, Section of Cardiovascular Diseases, University of Brescia, Brescia, Italy. enrico.vizzardi@tin.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Ermanna
authors.initials: E
authors.lastname: Chiari
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Tania
authors.initials: T
authors.lastname: Bordonali
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
authors.forename: Livio Dei
authors.initials: LD
authors.lastname: Cas
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015897:Comorbidity; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D016019:Survival Analysis; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000401:mortality*