Document Detail

The 'TEI-index' is preload dependent and can be measured by transoesophageal echocardiography during mechanical ventilation.
MedLine Citation:
PMID:  14649338     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: The Doppler-derived echocardiographic TEI-index, defined as the sum of the left ventricular isovolumic contraction and isovolumic relaxation times divided by ejection time, quantifies combined systolic and diastolic ventricular functions. The index has been proposed to be independent of arterial pressure and heart rate, implying a broad clinical usefulness. However, it is unclear whether the index is preload independent. We assessed whether and to what degree the TEI-index is altered by left ventricular loading conditions, and the feasibility of measurement by transoesophageal echocardiography during anaesthesia and mechanical ventilation. METHODS: We studied 17 anaesthetized mechanically ventilated patients with coronary artery disease during variations in left ventricular preload evoked by head-up and head-down tilt, respectively. RESULTS: A head-down tilt increasing left ventricular end-diastolic area from 18.8 +/- 4 to 23.7 +/- 4 cm2 (P < 0.05) significantly decreased the TEI-index from 0.5 +/- 0.17 to 0.33 +/- 0.15 (P < 0.05). In contrast, the TEI-index remained unchanged with decreased left ventricular preload (14.4 +/- 3.7 cm2) during head-up tilt. CONCLUSIONS: An increase in preload decreases the TEI-index indicating its sensitivity to acute increases in left ventricular preload. The TEI-index can be measured perioperatively by transoesophageal echocardiography.
J T Lutz; R Giebler; J Peters
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  20     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-27     Completed Date:  2004-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  872-7     Citation Subset:  IM    
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany.
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MeSH Terms
Analysis of Variance
Anesthesia, General
Coronary Artery Bypass
Coronary Artery Disease / ultrasonography*
Echocardiography, Doppler, Pulsed
Echocardiography, Transesophageal*
Head-Down Tilt / physiology
Hemodynamics / physiology
Monitoring, Intraoperative / methods
Posture / physiology
Respiration, Artificial*
Ventricular Function, Left / physiology*
Comment In:
Eur J Anaesthesiol. 2005 Feb;22(2):154-5   [PMID:  15816596 ]

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