Feasibility study on evaluating right ventricular diastolic function by new Tei’-Index

Abstract

Objective: Doppler-derived myocardial performance index (Tei) has been used in the evaluation of right ventricular (RV) function. However, the usage in isolated diastolic dysfunction is limited.We sought to find a new Tei’-index that is more appropriate for evaluating isolated diastolic dysfunction (IDD) based on the symmetry of cardiac structure and function. Methods: 21 patients with impaired RV relaxation were compared to 44 control subjects. Tei and Tei’ including their components, isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), the ejection time (ET), and RV rapid filling time (RFT) were measured from RV outflow and tricuspid inflow Doppler velocity profiles. Results: Tei-index have no change between IDD group and control subjects (0.21 ± 0.08 vs 0.23 ± 0.07 PNS). The Tei’-index was significantly shortened in IDD group(0.24 ± 0.09 vs 0.32 ± 0.12,p＜0.05).The decrease in Tei’-index was due to the prolongation of both IRT and RFT, and in the abbreviation of ICT. Tei’-index cutoff value of ≥0.31 identified impaired RV relaxation with a sensitivity of 50 % and specificity of 86 %.We also find that the Tei’-index correlated well with doppler measures of diastolic parameters like E/A, E/e’, DT, which suggests its potential use as a noninvasive indicator of the right ventricular (RV) relaxation in patients with heart failure of different causes. Conclusion: New Tei's index is highly effective and specific in the evaluation of early diastolic dysfunction of right ventricle, and can be used as an indicator for the detection of IDD in clinic.

Keywords

• Echocardiography
• Myocardial performance index (Tei-index)
• Isolated diastolic dysfunction
• Right ventricular function