Document Detail


Detection of left ventricular dysfunction with Tei index in normal ejection fraction patients with mitral regurgitation before mitral valve surgery.
MedLine Citation:
PMID:  19327432     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ejection fraction (EF) was not considered a reliable parameter of left ventricular (LV) function and was normal in most patients with chronic mitral regurgitation (MR), whereas LV dysfunction expressed as decreased EF was often shown after mitral valve surgery. This study sought the ability of the Tei index to detect latent LV dysfunction in patients with MR and apparently normal EF. One hundred eight patients with apparently normal EF (EF > or =50%) and chronic severe MR who underwent mitral valve repair were investigated. EF was significantly decreased after surgery and LV dysfunction (EF <50%) was shown in 37 patients (34% of all patients). The preoperative Tei index significantly correlated with postoperative EF in all patients (r = -0.64, p <0.0001) and asymptomatic patients (n = 44; r = -0.57, p <0.0001). By setting the preoperative Tei index >0.5 to predict postoperative EF <50%, this index had sensitivity, specificity, and accuracy of 89%, 85%, and 86% in all patients and 80%, 85%, and 84% in asymptomatic patients, respectively. In conclusion, a preoperative Tei index >0.5 allowed prediction of postoperative LV dysfunction in patients with MR with apparently normal EF. Thus, earlier surgery is recommended in asymptomatic patients with MR with normal EF, but Tei index >0.5.
Authors:
Kunitsugu Takasaki; A Marc Gillinov; Tetsuhiro Yamano; Yoshiki Matsumura; Manotomo Toyono; Takahiro Shiota
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-07
Journal Detail:
Title:  The American journal of cardiology     Volume:  103     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1011-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Echocardiography, Doppler / methods*
Female
Heart Valve Prosthesis Implantation / methods*
Humans
Male
Middle Aged
Mitral Valve Insufficiency / complications*,  surgery,  ultrasonography
Preoperative Care / methods*
ROC Curve
Stroke Volume / physiology*
Ventricular Dysfunction, Left / etiology,  physiopathology,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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