Advertisement

Pediatric Cardiology

, Volume 25, Issue 2, pp 131–136 | Cite as

Tei Index Determined by Tissue Doppler Imaging in Patients with Pulmonary Regurgitation After Repair of Tetralogy of Fallot

  • K. Yasuoka
  • K. Harada
  • M. Toyono
  • M. Tamura
  • F. Yamamoto
Original Article

Abstract

The myocardial performance index (Tei index) determined by the pulsed Doppler method is a simple and noninvasive measurement for assessing global right ventricular (RV) function. This index can also be obtained by tissue Doppler imaging (TDI). The effects of significant pulmonary regurgitation (PR) on the determination of the Tei index by these two methods have not been investigated. We examined 15 patients (6.3 ± 2.2 years) with significant PR after repair of tetralogy of Fallot (TOF) and 24 age-matched healthy children. Myocardial wall motion velocities at the tricuspid annulus were assessed during systole (Sa), early diastole (Ea), and late diastole (Aa) from a four-chamber view. Pulsed Doppler–Tei index and TDI–Tei index were measured as reported previously. The Tei index obtained by the pulsed Doppler method in TOF patients did not differ from that in normal children (0.30 ± 0. 12 vs 0.32 ± 0.07, p = not significant). TDI showed that TOF patients had significantly decreased Ea, Aa, and Sa velocities compared to those of normal children. Both isovolumic contraction time and isovolumic relaxation time in TOF patients were significantly longer than those in normal children (88 ± 18 vs 62 ± 23 msec and 46 ± 11 vs 21 ± 12 msec, respectively; p < 0.0001), although the duration of Sa did not differ between the two groups. Consequently, the Tei index as measured by TDI was significantly greater in TOF patients than in normal children (0.48 ± 0.07 vs 0.30 ± 0.07, p < 0.0001). The Tei index measured by the pulsed Doppler method is limited in its ability to assess RV function in patients with significant PR. However, the Tei index determined by TDI is a sensitive indicator of RV function in these patients, and it appears to be a promising new means of assessing global RV function in patients with significant PR.

Keywords

Tissue Doppler imaging Tei index Tetralogy of Fallot Pulmonary regurgitation 

References

  1. Abd, EI, Rahman, MY, Abdul-Khaliq, H,  et al. 2002Value of the new Doppler-derived myocardial performance index for the evaluation of right and left ventricular function following repair of tetralogy of Fallot.Pediatr Cardiol23502507CrossRefPubMedGoogle Scholar
  2. Bland, JM, Altman, DG 1986Statistical methods for assessing agreement between two methods of clinical measurements.Lancet1307310PubMedGoogle Scholar
  3. Burgess, MI, Mogulkoc, N, Bright-Thomas, RJ, Bishop, P, Egan, JJ, Ray, SG 2002Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease.J Am Soc Echocardiogr15633639CrossRefPubMedGoogle Scholar
  4. Caso, P, Galderisi, M, D’Andrea, A,  et al. 2002Analysis by pulsed Doppler tissue imaging of ventricular interaction in long-distance competitive swimmers.Am J Cardiol90193197CrossRefPubMedGoogle Scholar
  5. Eiden, BW, O’Leary, PW, Tei, C, Seward, JB 2000Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease.Am J Cardiol86654658CrossRefPubMedGoogle Scholar
  6. Eiden, BW, Tei, C, O’Leary, PW, Cetta, F, Seward, JB 1998Nongeometric quantitative assessment of right and left ventricular function: myocardial performance index in normal children and patients with Ebstein anomaly.J Am Soc Echocardiogr172849856Google Scholar
  7. Fommelt, PC, Ballweg, JA, Whistone, BN 2002RV DTI in tetralogy of Fallot s/p repair—evidence of systolic and diastolic dysfunction in asymptomatic children and young adults.J Am Soc Echocardiogr15S2(abstract)Google Scholar
  8. Goldberg, SJ, Allen, HD 1985Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation.Am J Cardiol5613135(abstract)PubMedGoogle Scholar
  9. Harada, K, Takahashi, Y, Shiota, T,  et al. 1995Effect of heart rate on left ventricular diastolic filling patterns assessed by Doppler echocardiography in normal infants.Am J Cardiol76634636(abstract)CrossRefPubMedGoogle Scholar
  10. Harada, K, Tamura, M, Toyono, M, Oyama, K, Takada, G 2001Assessment of global left ventricular function by tissue Doppler imaging.Am J Cardiol88927932(abstract)CrossRefPubMedGoogle Scholar
  11. Harada, K, Tamura, M, Toyono, M, Yasuoka, K 2002Comparison of the right ventricular Tei index by tissue Doppler imaging to that obtained by pulsed Doppler in children without heart disease.Am J Cardiol90566569(abstract)CrossRefPubMedGoogle Scholar
  12. Isaaz, K, del Romeral, LM, Lee, E, Schiller, NB 1993Quantitation of the motion of the cardiac base in normal subjects by Doppler echocardiography.J Am Soc Echocardiogr6166176(abstract)PubMedGoogle Scholar
  13. Ishii, M, Eto, G, Tsutsumi, T,  et al. 2000Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: a right ventricular myocardial performance index.Pediatr Cardiol217416421(abstract)CrossRefGoogle Scholar
  14. Mori, Y, Rice, MJ, McDonald, RW, Wantikun, S, Harada, K, Shan, DJ 2001Evaluation of systolic and diastolic ventricular performance of the right ventricle in fetuses with ductal constriction using the Doppler Tei index.Am J Cardiol8811731178(abstract)CrossRefPubMedGoogle Scholar
  15. Murphy, JB, Gersh, BJ, Mair, DD,  et al. 1993Long-term outcome in patients undergoing repair of tetralogy of Fallot.N Engl J Med329593599(abstract)CrossRefPubMedGoogle Scholar
  16. Myhre, ES, Slinker, BK, LeWinter, MM 1992Absence of right ventricular isovolumic relaxation in open-chest anaestethized dogs.Am J Physiol263587590(abstract)Google Scholar
  17. Paul, JJ, Puchalski, MD, Tani, LY, Minich, LL 2002Is the Tei index useful in patients with significant pulmonary regurgitation?J Am Soc Echocardiogr15482(abstract)Google Scholar
  18. Raizada, V, Sahn, DJ, Covell, JW 1988Factors influencing late right ventricular ejection.Cardiovasc Res22244248(abstract)PubMedGoogle Scholar
  19. Rychik, J, Tian, Z-Y 1996Quantitative assessment of myocardial tissue velocities in normal children with Doppler tissue imaging.Am J Cardiol7712541257(abstract)CrossRefPubMedGoogle Scholar
  20. Sebbag, I, Rudski, L, Therrien, J, Hirsch, A, Langlenben, D 2001Effect of chronic infusion of Epoprostenol on echocardiographic right ventricular myocardial performance index and its relation to clinical outcome in patients with primary pulmonary hypertention.Am J Cardiol8810601063(abstract)CrossRefPubMedGoogle Scholar
  21. Tei, C, Dujaradin, KS, Hodge, DO,  et al. 1996Doppler echocardiographic index for assessment of global right ventricular function.J Am Soc Echocardiogr9838847(abstract)PubMedGoogle Scholar
  22. Tei, C, Nishimura, RA, Seward, JB, Tajik, AJ 1997Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements.J Am Soc Echocardiogr10169178(abstract)PubMedGoogle Scholar
  23. Tsutsumi, T, Ishii, M, Eto, G, Hota, M, Kato, M 1999Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index.Pediatr Int41722727(abstract)CrossRefPubMedGoogle Scholar
  24. Vliegen, HW, Van Straten, A, De Roos, A,  et al. 2002Magnetic resonance imaging to assess the hemodymanic effects of pulmonary valve replacement in adults late after repair of tetralogy of Fallot.Circulation10617031707(abstract)Google Scholar
  25. Vogel, M, Sponring, J, Cullen, S, Deanfield, JE, Redington, AN 2001Regional wall motion and abnormalities of electrical depolarization and repolarization in patients after surgical repair of tetralogy of Fallot.Circulation10316691673(abstract)Google Scholar
  26. Weidermann, F, Eyskens, B, Mertens, L,  et al. 2002Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot.Am J Cardiol90133138(abstract)CrossRefPubMedGoogle Scholar
  27. Williams, RV, Ritter, S, Tani, LY, Fagotto, LT, Minich, LL 2000Quantitative assessment of ventricular function in children with single ventricles using the Doppler myocardial performance index.Am J Cardiol8611061110(abstract)CrossRefPubMedGoogle Scholar
  28. Yeo, TC, Dujardin, KS, Tei, C, Mahoney, DW, McGoon, MD, Seward, JB 1998Value of a Doppler-derived index combining systolic and diastolic time intervals in predicting outcome in primary pulmonary hypertension.Am J Cardiol8111571161(abstract)CrossRefPubMedGoogle Scholar
  29. Yu, CM, Sanderson, JE, Chan, S, Yeung, L, Hung, YT, Woo, KS 1996Right ventricular diastolic dysfunction in heart failure.Circulation6315091514(abstract)Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • K. Yasuoka
    • 1
  • K. Harada
    • 1
  • M. Toyono
    • 1
  • M. Tamura
    • 1
  • F. Yamamoto
    • 1
  1. 1.Departments of Pediatrics and Cardiovascular SurgeryAkita University School of Medicine, 1-1-1 Hondo, Akita 010-8543Japan

Personalised recommendations