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

Yasuoka, Kenji; Harada, Kenji; Toyono, Manatomo; Tamura, Masazumi; Yamamoto, Fumio

doi:10.1007/s00246-003-0514-3

Cited by 81 publications

(73 citation statements)

References 27 publications

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“…Yasuoka et al (34) stated that MPI assessed by tissue Doppler echocardiography (rather than pulse wave Doppler echocardiography) successfully pointed out the RV functions of the patients who developed PR after total correction of ToF. The present study also showed that LV and RV MPI values obtained by pulse tissue Doppler were significantly increased in the patients with ToF.…”

Section: Discussionsupporting

confidence: 69%

Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study

Şaylan¹,

Çevik²,

Tavli³

2012

Anadolu Kardiyol Derg

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Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study ABSTRACTObjective: The present study aims to study the relationship between tissue Doppler echocardiography (TDE) indices of right ventricle and exercise capacity in patients after total correction for tetralogy of Fallot (ToF). Methods: This cross-sectional observational study included 20 patients, after undergoing total correction procedure for ToF diagnosed with mild/moderate pulmonary regurgitation and 30 age-matched healthy children. In the postoperative period, patients were invited to hospital for evaluation of the ventricular functions by 2D, M-mode, Doppler (DE) echocardiography and TDE and exercise testing to evaluate the effort capacity. Statistical analysis was performed using Mann-Whitney U and Chi-square tests, and Pearson correlation analysis. Results: Compared with the controls; the mitral annular peak systolic flow velocity (Sm) value was significantly lower, while isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and myocardial performance index (MPI) values obtained at the tricuspid and mitral (MV) valves were significantly higher (p<0.05 for all) in patients after ToF repair. There was a negative correlation between the exercise period and the total correction age (r=-0.20, p=0.015) and the same negative correlation existed between the exercise period and METS (r=-0.25, p=0.010). MV IVCT with DE and TDE was found to be correlated with METS (r=-0.45, p=0.04). Left ventricular MPI was found to be correlated with maximum heart rate (r=-0.20, p=0.03). By DE, tricuspid valve deceleration time and Sm peak flow velocity with TDE were significantly correlated with METS (r=-0.30, p=0.04; r=-025, p=0.005, respectively). MPI calculated with TDE was correlated with maximum heart rate (r=-0.15, p<0.01). Conclusion: Even if patients, undergone total correction surgery for ToF were asymptomatic or had minimal clinical symptoms, MPI index assessed by pulse wave TDE and exercise testing may allow early diagnosis of right ventricle dysfunction. Yöntemler: Enine kesitli-gözlemsel çalışmaya, Fallot Tetralojisi tanısı ile tam düzeltme operasyonu uygulanmış, hafif-orta derecede pulmoner regürjitasyonu olan 20 hasta ile kontrol grubu olarak 30 sağlıklı çocuk dahil edildi. Hastalar, ameliyat sonrası dönemde 2D, M mod, Doppler ekokardiyografi ve doku Doppler ekokardiyografi ile ventrikül fonksiyonları, egzersiz testi ile efor kapasiteleri değerlendirilmek üzere hastaneye çağrılmıştır. İstatistiksel analiz Mann-Whitney U ve Ki-kare testi ve Pearson korelasyon analizi ile yapıldı. Bulgular: Kontrol grubu ile karşılaştırıldığında, Fallot tetralojili hasta grubunda mitral annüler pik sistolik akım hız (Sm) değeri belirgin olarak düşük, triküspit ve mitral (MV) kapaktan elde edilen izovolümik relaksasyon zamanı (IVRT), izovolümik kontraksiyon zamanı (IVCT) ve miyokart performans indeksi (MPI) değerleri daha yüksek idi (tümü için p<0....

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Section: Discussionsupporting

confidence: 69%

Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study

Şaylan¹,

Çevik²,

Tavli³

2012

Anadolu Kardiyol Derg

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“…[18] In significant PVI, there is an elevation in RV ET obtained with PW Doppler and decrease in MPI values, while there is an elevation in ICT and IRT calculated with PW TD, shortening in ET and elevation in MPI value. Although MPI values obtained with PW are not sufficient to show the global function of RV, Yasuoka et al [19] indicates that MPI obtained with PW TD perfectly reflects the RV function in patients who develop PVI in postoperative period and that, as in our study, MPI values calculated with PW TD are distinctively high in patients with complete repair. Abd El Rahman et al [20] investigated RV MPI with PW Doppler method in patients with the complete repair of TOF and concluded that MPI values were below normal in 76.5% of patients.…”

Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

“…[19] The presence of both systolic and diastolic dysfunction causes myocardial relaxation anomaly and the elevation of ICT. [19] There is an elevation in ICT and IRT in TOF patients, while ET, myocardial s, e and a velocities decrease. Elevated IRT and a decrease in myocardial e velocity constitute an early sign of delayed RV relaxation; a decrease in myocardial e velocity is an early sign of restrictive RV physiology, while elevated ICT is an early sign of delayed systolic activation.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Gürsu

Varan

Erdoğan

et al. 2018

Turk Gogus Kalp Dama

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Background:This study aims to investigate the efficacy of tissue Doppler echocardiography for the diagnosis of right ventricular dysfunction and for the evaluation of the response to pulmonary valve replacement. Methods: Between December 2008 and December 2010, a total of 15 patients (8 males, 7 females; mean age: 14.5±4.5 years; range, 7 to 22 years) with pulmonary valve insufficiency in the follow-up of total correction of tetralogy of Fallot who underwent pulmonary valve replacement were included in the study. Echocardiographic imaging was performed before and one, three, and six months after replacement. Using pulse wave Doppler, early diastolic E and late diastolic A waves were measured in the flow velocity curve of tricuspid valve. Tissue Doppler measurements were made from the basal segment of right ventricular free wall and interventricular septum. S, e, and a myocardial velocities, isometric contraction time, isovolumetric relaxation time and ejection time were measured. Myocardial performance index was calculated for each patient. Results:In pre-pulmonary valve replacement phase, s, e, a velocities and ejection time were lower in the interventricular septum compared to the basal segment of right ventricular free wall, while isometric contraction time, isovolumetric relaxation time and myocardial performance index values were higher. In the first post-replacement month, there was a significant decrease in the s value of interventricular septum, compared to pre-pulmonary valve replacement period; isometric contraction time decreased and myocardial performance index increased in the first postpulmonary valve replacement month in the free wall of right ventricle, while isovolumetric relaxation time decreased in the postoperative third month, and s velocity, isometric contraction time and myocardial performance index increased in the postoperative sixth month. Pre-pulmonary valve replacement tissue Doppler values at the septum showed that myocardial systolic and diastolic dysfunction developed earlier than the basal segment of right ventricular free wall. This result showed that right ventricular recovery was not complete in the sixth post-pulmonary valve replacement month. Conclusion:Tissue Doppler can show right ventricular dysfunction before replacement, but it may be insufficient to visualize right ventricular recovery until six months after treatment.

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“…In PHT, both systolic and diastolic dysfunction occur; consequently, we used the Tei index, which combines diastolic and systolic parameters, to assess global RV function (26,27,33). The Tei index is a powerful tool with significant prognosis for RV dysfunction in primary PHT (27,34).…”

Section: Discussionmentioning

confidence: 99%

Doppler tissue imaging in assessment of pulmonary hypertension-induced right ventricle dysfunction

Boissière¹,

Gautier²,

Machet³

et al. 2005

American Journal of Physiology-Heart and Circulatory Physiology

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-We aimed to assess the accuracy of Doppler tissue imaging (DTI) in detecting right ventricle (RV) dysfunction and electromechanical coupling alteration following pulmonary hypertension (PHT) in rat. PHT was induced by chronic hypoxia exposure (hypoxic PHT) or monocrotaline treatment (monocrotaline PHT). In both PHT models, we observed transparietal RV pressure increase and remodeling, including hypertrophy and dilation. Conventional echocardiography provided evidence for pulmonary outflow impairment with midsystolic notch and acceleration time decrease in PHT groups (21.7 Ϯ 1.6 and 13.2 Ϯ 2.9 ms in hypoxic and monocrotaline PHT groups vs. 28.1 Ϯ 1.0 ms in control). RV shortening fraction was decreased in the monocrotaline PHT group compared with the hypoxic PHT and control groups. Combining conventional Doppler and DTI was more helpful to detect RV diastolic dysfunction in the monocrotaline PHT group (E/Ea ratio ϭ 17.0 Ϯ 1.4) compared with the hypoxic PHT and control groups (11.5 Ϯ 0.7 and 10.2 Ϯ 0.4, respectively). Tei index measured using DTI highlighted global RV dysfunction in the monocrotaline PHT group (1.36 Ϯ 0.24 vs. 0.92 Ϯ 0.05 and 0.86 Ϯ 0.05 in the hypoxic PHT and control groups, respectively). Q-S m time measured from the onset of Q wave to the onset of DTI S m wave was increased in both PHT groups. PHT-induced electromechanical coupling alteration was confirmed by in vitro activation-contraction delay measurements on isolated RV papillary muscle, and both Q-S m time and activation-contraction delay were correlated with PHT severity. We demonstrated that Q-Sm time measured in DTI was an easily and convenient index to detect early RV electromechanical coupling alteration in both moderate and severe PHT. echocardiography; hypertrophy; right ventricular remodeling CHRONIC ALVEOLAR HYPOXIA, which often occurs in patients suffering from chronic obstructive pulmonary diseases, secondarily induces a sustained increase in pulmonary artery resistance. The subsequent pulmonary artery hypertension (PHT) leads to right ventricle (RV) pressure overload and hypertrophy (22).Conventional transthoracic echocardiography is widely used to detect PHT in humans and animal models (14, 18). The standard parameters are the RV free wall thickening recorded in time-motion (TM) mode, the presence of mild-systolic notch, and the acceleration time decrease in the pulmonary outflow spectrum recorded in pulsed-Doppler mode. Nevertheless, a more extensive assessment of PHT-induced RV dysfunction remains difficult using conventional echocardiography. Indeed, accuracy of RV systolic and diastolic functions assessment is limited by complex anatomy and geometry of the ventricle.The Tei index, which combines both systolic and diastolic parameters, was suggested to determine global myocardial performance (27). It has been used in the assessment of RV dysfunction, especially in PHT (26). In conventional pulsed Doppler, the Tei index derives from both isovolumic contraction and relaxation times (IVCT and IVRT) as well as ejection time of...

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

Cited by 81 publications

References 27 publications

Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study

Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study

Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Doppler tissue imaging in assessment of pulmonary hypertension-induced right ventricle dysfunction

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