title: Improvement of myocardial performance (Tei) index closely reflects intrinsic improvement of cardiac function: assessment in revascularized hibernating myocardium.
abstract: BACKGROUND
  Myocardial performance index (MPI), or Tei index, is an indicator of systolic and diastolic myocardial function. MPI increases in case of cardiac dysfunction; however, whether reversal of left ventricular dysfunction is also reflected by concomitant improvement (i.e., decrease) of MPI is unknown.
  
  
  METHODS
  Fifty-two patients with chronic ischemic cardiomyopathy and viable myocardium by dobutamine stress echocardiography were studied by echocardiography before and more than 4 months after cardiac revascularization. Patients were in optimal medical therapy, which remained unchanged following revascularization.
  
  
  RESULTS
  At baseline, ejection fraction (EF: 32 ± 6%) and wall motion score index (WMSI: 2.37 ± 0.32) were impaired, and MPI averaged 0.71 ± 0.19. Revascularization markedly improved EF (44 ± 10%, P < 0.0001) and WMSI (1.77 ± 0.44, P < 0.0001). MPI also improved (0.59 ± 0.26, P < 0.0001), and its decrease was significantly correlated with the improvement in EF (r =-0.68, P < 0.0001) and to the extent of viable myocardium (r =-0.45, P = 0.0007). Responders to revascularization (≥5% increase in EF at follow-up, n = 40% and 77%) achieved a significant improvement in MPI at follow-up in contrast with nonresponders (-23 ± 25% vs. 0.02 ± 0.18%, P = 0.001). Improvement in MPI was largely driven by a significant reduction in isovolumic contraction time (P < 0.001) with consequent prolongation of the ejection phase.
  
  
  CONCLUSIONS
  In patients with chronic ischemic cardiomyopathy, MPI improves along with recovery of function, reflecting the intrinsic improvement of viable segments induced by revascularization.
authors: Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy.
authors: Erberto
authors: E
authors: Carluccio
authors: Paolo
authors: P
authors: Biagioli
authors: Gianfranco
authors: G
authors: Alunni
authors: Adriano
authors: A
authors: Murrone
authors: Cinzia
authors: C
authors: Zuchi
authors: Emilia
authors: E
authors: Biscottini
authors: Rosanna
authors: R
authors: Lauciello
authors: Paola
authors: P
authors: Pantano
authors: Federico
authors: F
authors: Gentile
authors: Rick A
authors: RA
authors: Nishimura
authors: Giuseppe
authors: G
authors: Ambrosio
mesh_terms: D000369:Aged, 80 and over; D000465:Algorithms; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D009204:Myocardial Revascularization; D017682:Myocardial Stunning / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery