Myocardial performance index as an echocardiographic predictor of early in-hospital heart failure during first acute anterior ST-elevation myocardial infarction

Abstract

ObjectivesTo determine the value of Myocardial Performance Index (MPI) as an echocardiographic predictor of early in-hospital heart failure (HF) during first acute anterior ST-Elevation Myocardial Infarction (STEMI).BackgroundMyocardial infarction induces variable degrees of impairment in left ventricular (LV) systolic and diastolic functions. The ejection fraction (EF) and transmitral flow, the most frequently used methods for evaluation of systolic and diastolic functions respectively, both have considerable limitations. The MPI is a single parameter, capable of estimating combined systolic and diastolic performance and lacks such limitations.MethodsWe enrolled 60 patients presented with a first acute anterior STEMI who have undergone primary PCI. Echocardiography was done within 24 h of chest pain with measurement of MPI. The LV MPI was calculated as (isovolumic contraction time “ICT” + relaxation time “IRT”)/Ejection time “ET”. Besides, clinical and echocardiographic variables were analyzed and CHF was defined as Killip class ≥ II.ResultsEarly in-hospital HF occurred in 23 of patients (38%). Ejection fraction was found to have a highly significant negative correlation with the development of in-hospital HF (p = .0001), while MPI was found to have a highly significant positive correlation (p = .0001). A cut-off point of MPI > 0.73 showed a very high specificity (94.6%) and sensitivity (78.3%) for identifying patients with HF. On the other hand, a cut-off point of EF ≤ 33% has shown 94.6% specificity and 56.5% sensitivity for HF prediction.ConclusionsThe MPI might be a strong predictor of in-hospital HF after first acute anterior STEMI.

The prognostic value of Tei index in acute myocardial infarction: a systematic review

“…Our search results yielded 144 potential inclusions and after detailed screening and review, a total of 16 studies were included in the review ( Fig. 2 ) ( 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ). These studies included 14 cohort studies and 2 matched control studies ( Table 1 ).…”

“…Abuomara et al . evaluated the value of a Tei index >0.73 compared to a LVEF ≤33% and found that the Tei index was more sensitive (78.3% vs 56.5%) with similar specificity (94.6% vs 94.6%) for in-hospital heart failure after AMI ( 6 ). Sasao et al .…”

“…An acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide ( 6 ) with known complications including congestive heart failure, functional and structural myocardial abnormalities, reinfarction and death. In the setting of an AMI, echocardiography is a well-established risk stratification tool ( 7 , 8 ).…”

<p>Relationship Between Isovolumic Acceleration (IVA) and TEI Index with Pro-BNP in Heart Failure</p>

“…31 One study showed that, after first myocardial infarction, elevated TEI index could be a predictor of early inhospital heart failure. 32 Lang found that BNP levels were elevated in patients with isolated diastolic dysfunction. 33 The extent of systolic dysfunction is not always associated with deterioration in functional status in HF patients.…”

Accuracy of three-dimensional systolic dyssynchrony and sphericity indexes for identifying early left ventricular remodelling after acute myocardial infarction

“…Cardiovascular diseases continue to be the leading cause of death worldwide (1). Heart failure (HF) remains one of the most severe complications following acute myocardial infarction (AMI) that highly affects morbidity and mortality (2). Early detection of patients with AMI at risk of development of HF is necessary to avoid the evolution of left ventricular (LV) dysfunction (1-4).…”