title: Myocardial Performance Index (Tei Index): A simple tool to identify cardiac dysfunction in patients with diabetes mellitus.
abstract: BACKGROUND
  Cardiac dysfunction is the major cause of morbidity and mortality in diabetes. Myocardial Performance Index (MPI/Tei Index) includes both systolic and diastolic time intervals to assess the global cardiac dysfunction. Our aim was to assess the MPI in patients with type 2 diabetes.
  
  
  METHODS
  This hospital-based analytic observational study was performed in the tertiary care center. The conventional Doppler parameters, tissue Doppler-derived E/E' and MPI, were measured in all patients.
  
  
  RESULTS
  100 patients with type 2 diabetes were included in the study. 65 patients showed diastolic dysfunction, 33 with Grade I diastolic dysfunction, 23 with Grade II diastolic dysfunction, and 14 patients with Grade III diastolic dysfunction. The conventional Doppler showed abnormality in 44% of patients (33 patients with Grade I and 14 patient with Grade III). 23 patients were in Grade II diastolic dysfunction (12 patients showed reversal E/A on valsalva maneuver and 11 patients showed abnormality in tissue Doppler-derived E/E', E/E'>15). MPI with cut-off 0.36 was found to have 94% sensitivity, 100 specificity, and 94% PPV for the detection of cardiac dysfunction. MPI negatively correlated with systolic dysfunction (rho=0.455, p<0.001) and positively correlated with grade of diastolic dysfunction (rho=0.832, p<0.001) and NYHA grading of dyspnea (rho=0.872, p<0.001) CONCLUSIONS: MPI as a single parameter can be used for assessment in diabetic cardiac dysfunction.
authors.affiliation: Department of Endocrinology, Seth G S Medical College, KEM Hospital, Parel, Mumbai 400012, India. Electronic address: manjunath.r.goroshi@gmail.com.
authors.forename: Manjunath
authors.initials: M
authors.lastname: Goroshi
authors.affiliation: Professor, Department of Medicine, Govt. Medical College, Nagpur, Maharashtra, 440003, India.
authors.forename: Dipti
authors.initials: D
authors.lastname: Chand
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Diabetic cardiomyopathy; Diastolic dysfunction; MPI; Tei Index; Tissue Doppler