Quantitation of the Global Right Ventricular Function in Children with Normal Heart and Congenital Heart Disease: A Right Ventricular Myocardial Performance Index

Abstract

Although the assessment of right ventricular (RV) function is important in the clinical management of children with congenital heart disease, available imaging techniques have been limited because of the complex geometry of the right ventricle. A new Doppler index combining systolic and diastolic time intervals (the Tei index) has been reported to be useful for the assessment of global RV function in adults. However, normal values in children, age-related changes, and the clinical utility of the Tei index with regard to congenital heart disease have not been demonstrated. The purpose of this study was to prospectively assess RV function in children with normal heart and congenital heart disease using the Tei index. The subjects included 150 healthy children and 43 patients with congenital heart disease (35 patients with atrial septal defects and 8 patients who had had a Senning operation). The index was defined as the sum of isovolumetric contraction time and isovolumetric relaxation time divided by ejection time and was measured from conventional RV outflow and inflow Doppler velocity profiles. The Tei index was not affected by age in healthy children (0.24 +/- 0.04). There was a significant difference in index rating between patients who had had a Senning operation (0.58 +/- 0.09) and healthy children (p < 0.01), but there was no significant difference between children with atrial septal defect (0.25 +/- 0.13) and healthy children. The Tei index is a feasible approach to use when assessing global RV function in children with congenital heart disease.

Evaluation of Right Ventricular Tei Index (Index of Myocardial Performance) in Healthy Dogs and Dogs with Tricuspid Regurgitation

“…The Tei index is defined as the sum of isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) divided by ejection time (ET), and it has been reported to reflect comprehensive cardiac function, including systolic and diastolic performances, in humans [36,39]. The Tei index is a simple and reproducible technique, and is relatively independent of heart rate [4,39] and age [19]. In addition, the Tei index has been demonstrated to be clinically useful in estimating the prognosis in human patients with primary PH [37,44], DCM [9], cardiac amyloidosis [38], and myocardial infarction [32].…”

Electrical Resynchronization

“…[1][2][3] Whereas left ventricular (LV) failure is well studied, the therapeutic approach to right ventricular (RV) failure is largely empirical, and clinical trial data are nearly nonexistent.…”

Usefulness of a New Doppler Index for Assessing Both Ventricular Functions and Pulmonary Circulation in Newborn Piglet With Hypoxic Pulmonary Hypertension

“…Thus, serial evaluation of pulmonary circulation and cardiac function is important to assess accurately the clinical course, the efficacy of treatment, and the prognosis. The available imaging techniques have been limited, but a new Doppler echocardiographic index combining systolic and diastolic time intervals (the Tei index) has been reported to be useful for the assessment of global function of the right ventricle (RV) and left ventricle (LV), independent of geometric assumptions, heart rate (HR), and blood pressure (3)(4)(5)(6)(7)(8)(9). The Tei index is defined as the sum of isovolumetric contraction time and isovolumetric relaxation time divided by the ejection time.…”