Effect of Preload and Heart Rate on the Doppler and Tissue Doppler‐derived Myocardial Performance Index

Abstract

SummaryDoppler-derived myocardial performance index (MPI) has been described as a noninvasive measurement of LV function. Our aim was to investigate the effect of hemodialysis related volume reduction and heart rate changes on the Doppler-derived LV MPI, and Doppler tissue imaging (DTI) derived left and right ventricular MPI.Method: The study group comprised 32 consecutive patients (mean age: 43 ± 18 yrs) undergoing hemodialysis. Patients underwent echocardiography before and immediately after hemodialysis session. Left and right ventricular MPI derived from conventional pulsed-wave Doppler and DTI was calculated. The difference in MPI, heart rate and body weight was calculated before and after hemodialysis.Results: Doppler-derived LV MPI, and right ventricular MPI obtained by DTI were increased (p = 0.05) but the LV MPI obtained by DTI was unchanged after hemodialysis. There is a significant positive correlation between the Doppler-derived LV MPI difference and volume reduction (r = 0.38, p = 0.032). The heart rate difference was correlated with Doppler-derived LV MPI difference, and DTI derived right ventricular MPI difference (r = 0.38, p = 0.034; r = 0.48, p = 0.006, respectively). Whereas, DTI derived LV MPI difference was not correlated with heart rate difference. By the multivariate analysis, there was no correlation between Doppler-derived LV MPI difference with heart rate difference, and volume reduction. Right ventricular MPI difference correlated with heart rate difference (r = 0.41, p = 0.021) but not with volume reduction. Doppler-derived MPI is partially influenced by preload and heart rate changes. However, DTI derived LV MPI is not influenced by preload and heart rate changes.

Isolated Coronary Ectasia is Associated with Impairment of Left Ventricular Myocardial Performance and Aortic Elastic Properties

“…Ozdemir et al found that increased Doppler-derived MPI was related to mortality in a variety of cardiac diseases [37]. And also his study had shown that while Doppler-derived MPI was affected by preload and heart rate, TDEderived MPI was not affected by either [37]. In this study, left ventricular MPI was significantly higher in CAE patients than the control group.…”

“…Also, MPI is related to left ventricular dysfunction and clinical severity of heart failure and is a powerful parameter for the prognostic assessment of these patients [36]. Ozdemir et al found that increased Doppler-derived MPI was related to mortality in a variety of cardiac diseases [37]. And also his study had shown that while Doppler-derived MPI was affected by preload and heart rate, TDEderived MPI was not affected by either [37].…”

Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients

“…Thus, the MPI obtained by TDI can reduce inaccuracy due to heart-rate fluctuation [12,26]. A recently published study, Ozdemir et al [27], investigated the effect of hemodialysis-related volume reduction and heart-rate changes on the LV MPI using conventional PWD and MPI using TDI in adult ESRD patients. They showed that conventional PWD-derived MPI was influenced by preload and heart-rate changes.…”

Coronary Ectasia Is Associated with Impaired Left Ventricular Myocardial Performance in Patients without Significant Coronary Artery Stenosis

“…It has been previously shown that increased Doppler-derived MPI is related to mortality in a variety of cardiac diseases [28]. Ozdemir et al [28] have shown in their study that while Doppler-derived MPI is affected by preload and heart rate, TDE-derived MPI is not affected by either. In our study, left ventricular lateral wall, interventricular septum and mean MPI was significantly higher in CAE patients than the control group.…”

“…Also, MPI is related to left ventricular dysfunction and clinical severity of heart failure and is a powerful parameter for the prognostic assessment of these patients [27]. It has been previously shown that increased Doppler-derived MPI is related to mortality in a variety of cardiac diseases [28]. Ozdemir et al [28] have shown in their study that while Doppler-derived MPI is affected by preload and heart rate, TDE-derived MPI is not affected by either.…”