2012


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2012/№3

Role of Tei-index in evaluation of arterial hypertension therapy effectiveness

Vasyuk Yu. A., Khadzegova A. B., Ivanova S. V., Yushuk E. N., Amirbigshvili I. M., Matveeva O. S., Schupenina E. Yu., Khuchivaeva A. M., Nadina E. V., Sinitsyna I. A., Sadulaeva I. A.

Keywords: arterial hypertension, diastolic dysfunction of the left ventricle, myocardium performance index, EchoCG

DOI: 10.18087/rhfj.2012.3.1702

Relevance. It was found that patients with arterial hypertension along with diastolic LV often have also the impairment of systolic function. Having this in mind, it seems that separate evaluation of systolic and diastolic dysfunction could be rather questionable. It’s more appropriate to speak about the functional state of LV and right ventricular (RV) conjointly. On the background of the effective antihypertensive therapy improvement of systolic and diastolic function occurs, that might be evaluated with the help of the cardiac performance index. Objective. To determine the role of the ventricle performance index (Tei-index) in the evaluation of effectiveness of the antihypertensive therapy. Materials and methods. The study included 88 AH Patients (21 men, 67 women) and 24 healthy volunteers (9 men and 15 women). Diurnal monitoring of arterial pressure (APDM), two-dimensional EchoCG, Doppler EchoCG and tissue Doppler EchoCG. Results. In AP patients peak E speeds of LV and RV, as well as the value of ratio E / A of trans-mitra and transtricuspidal flows on the background of 6‑month antihypertensive therapy were not changed reliably whereas reliable dynamics of time values of transmitral and transtricuspidal flows were observed. In AH patients reduction of the Tei-index of LV due to reduction of duration of isovoluminous reduction in absence of reliable dynamics of speed values of transmitral blood flow testifies about improvement of the LV functional state. On the background of the conducted therapy values of regional Tei-index in the interventricular septum and the lateral wall of LV are reliably reducing, which testifies improvement of the functional state of corresponding LV walls. The analogous dynamics of Tei-index has place in the area of free wall of RV at the level of the tricuspidal ring. Conclusion. Reduction of Tei-index both global, evaluated by transmitral blood flow and regional, evaluated by tissue dopplerography of atrio-ventricular rings, is the earliest marker of LV and RV myocardium functional state improvement and it confirms the effect of the antihypertensive therapy conducted.
  1. Российское медицинское общество по артериальной гипертонии (РМОАГ), Всероссийское научное общество кардиологов (ВНОК). Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр). 2010 г. Доступно на: http: gipertonik.ru / files / recommendation-ag-2010.pdf
  2. Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr. 1997;10 (2):169–178.
  3. Алехин М. Н., Барт Б. Я., Ларина В. Н., Барт Ю. В. Миокардиальный индекс общей дисфункции сердца (Tei_индекс), возможности и ограничения Ультразвуковая и функциональная диагностика. 2007;1:119–125.
  4. Møller JE, Poulsen SH, Egstrup K. Effect of preload alternations on a new Doppler echocardiographic index of combined systolic and diastolic performance. J Am Soc Echocardiogr. 1999;12 (12):1065–1072.
  5. Tei C, Ling LH, Hodge DO et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol. 1995;26 (6):357–366.
  6. Poulsen SH, Nielsen JC, Andersen HR. The influence of heart rate on the Doppler-derived myocardial performance index. J Am Soc Echocardiogr. 2000;13 (5):379–384.
  7. Vonk MC, Sander MH, van den Hoogen FH et al. Right ventricle Tei-index: a tool to increase the accuracy of non-invasive detection of pulmonary arterial hypertension in connective tissue diseases. Eur J Echocardiogr. 2007;8 (5):317–321.
  8. Gillebert TC, Van de Veire N, De Buyzere ML, De Sutter J. Time intervals and global cardiac function. Use and limitations. Eur Heart J. 2004;25 (24):2185–2186.
  9. Lang RM, Bierig M, Devereux RB et al. American Society of Echocardiography’s Nomenclature and Standards Committee; Task Force on Chamber Quantification; American College of Cardiology Echocardiography Committee; American Heart Association; European Association of Echocardiography, European Society of Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7 (2):79–108.
  10. Nagueh SF, Appleton CP, Gillebert TC et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10 (2):165–193.
  11. Harjai KJ, Scott L, Vivekananthan K et al. The Tei index: a new prognostic index for patients with symptomatic heart failure. J Am Soc Echocardiogr. 2002;15 (9):864–868.
  12. Spencer KT, Weinert L, Avi VM et al. Automated calculation of the Tei index from signal averaged left ventricular acoustic quantification wave forms. J Am Soc Echocardiogr. 2002;15 (12):1485–1489.
Vasyuk Yu. A., Khadzegova A. B., Ivanova S. V. et al. Role of Tei-index in evaluation of arterial hypertension therapy effectiveness. Russian Heart Failure Journal. 2012;13(3):162-166

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