The myocardial performance index during low-dose dobutamine echocardiography in control subjects and patients with a recent myocardial infarction: a new index of left ventricular functional reserve?

Nørager, Betina; Husic, Mirza; Møller, Jacob Eifer; Egstrup, Kenneth

doi:10.1016/j.echo.2004.03.037

Cited by 10 publications

(10 citation statements)

References 18 publications

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“…17 Assessment of Tei index is relatively simple and not significantly time-consuming, although not completely immune from technical challenges in case of fast heart rate. However, we significantly add to the current literature by showing that the correlation between Tei index and LV contractility reserve is highly likely mediated by intrinsic correlation of Tei index with LV systolic more than diastolic functions; in fact, Tei index correlated with LV contractility reserve in the absence of a concomitant correlations between LV contractility reserve with pure indices of LV diastolic function.…”

Section: Discussionmentioning

confidence: 99%

“…13,15,16 In a recent study in patients with CHD, LV contractility reserve correlated with an indicator of LV systolic and diastolic function during dobutamine stress echo. 17 However, the extent to which LV contractility reserve impacts on preload-insensitive parameters of LV diastolic function remains to be clarified. Therefore, we evaluated a group of pa-tients with a wide range of LV systolic and diastolic functions to assess the impact of change in LV systolic performance on traditional and color Mmode Doppler parameters of LV diastolic function.…”

mentioning

confidence: 99%

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Traditional and Color M-Mode Parameters of Left Ventricular Diastolic Function During Low-dose Dobutamine Stress Echocardiography: Relations to Contractility Reserve

Palmieri

Innocenti

Agresti

et al. 2006

Journal of the American Society of Echocardiography

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Traditional and Color M-Mode Parameters of Left Ventricular Diastolic Function During Low-dose Dobutamine Stress Echocardiography: Relations to Contractility Reserve

Palmieri

Innocenti

Agresti

et al. 2006

Journal of the American Society of Echocardiography

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“…Several studies deal with assessment of the TEI index during dobutamine stress echocardiography. Nørager et al [11] demonstrated an increase in the index in a group of 50 patients with newly diagnosed myocardial infarction on echocardiography with a low dose dobutamine compared with 25 healthy volunteers. Changes in the TEI index provided a quantitative measurement of total functional reserve of the left ventricle in patients with myocardial infarction.…”

Section: Case Reportmentioning

confidence: 99%

Diabetic Cardiomyopathy - Heart Disease in Diabetes

Adamíková¹,

Bakala²,

Paterova³

et al. 2013

CMR

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Diabetic cardiomyopathy is defined as a finding of systolic and diastolic left ventricular dysfunction, myocardial dilation and left ventricular hypertrophy without the presence of macroangiopathy and hypertension. Causes include metabolic changes, myocardial fibrosis, microangiopathy as well as cardiovascular autonomic neuropathy leading to sympathetic denervation and alteration of myocardial perfusion. It comprises abnormalities in the control of heart rate as well as central and peripheral vascular dynamics. The diagnosis of diabetic cardiomyopathy affects significantly the prognosis in patients with diabetes. Echocardiography and nuclear medicine methods are used for diagnosis.

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“…MPI was calculated as (A 2 B)/B. 18 On the basis of our previous study, 6 we chose to categorise patients according to whether an decrease (improvement) or increase (deterioration) in MPI was observed after low-dose dobutamine infusion or peak DASE, respectively. Thus, as the cut off was prespecified, the possibility cannot be excluded that some patients were categorised incorrectly due to the intraobserver and interobserver variabilities in MPI measurements.…”

Section: Assessment Of Systolic Functionmentioning

confidence: 99%

“…Recently, MPI was found to correlate closely with invasive measures of LV systolic function during b adrenergic stimulation. 5 Furthermore, we have previously shown that MPI consistently improves, decreasing its value, during dobutamine stimulation in healthy people, 6 and MPI has been shown to increase (deteriorate) during dobutamine-induced ischaemia in patients with known or suspected coronary artery disease. 7 Brain natriuretic peptide (BNP) is a cardiac neurohormone that is secreted from the atria and ventricles in response to myocardial stretch, pressure overload and myocardial ischaemia.…”

mentioning

confidence: 97%

Changes in the Doppler myocardial performance index during dobutamine echocardiography: association with neurohormonal activation and prognosis after acute myocardial infarction

Nørager

Husic

Møller

et al. 2006

Heart

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Objectives: To test whether an increase in Doppler myocardial performance index (MPI) during dobutamine stress echocardiography, reflecting deterioration of overall left ventricular function, is associated with increased N-terminal pro-brain natriuretic peptide (NT-pro-BNP) concentration and provides prognostic information beyond conventional systolic wall motion analysis after acute myocardial infarction (AMI). Design: Prospective, observational study. Methods: Dobutamine-atropine stress echocardiography (DASE) and NT-pro-BNP were assessed five days after AMI in 109 consecutive patients. MPI was measured at rest and at low-dose (10 mg/kg/min) and peak dobutamine infusion (( 40 mg/kg/min with or without atropine). Main outcome measures: End point was a composite of cardiac death or readmission for heart failure or reinfarction. Results: In 35 patients (32%), MPI increased at low-dose DASE. This was associated with higher NT-pro-BNP concentrations (b = 0.30, p = 0.004). During a mean follow up of 27 (SD 7) months, 8 patients died of cardiac causes and 15 patients were readmitted for heart failure or reinfarction. On Cox regression analysis, an increase in MPI at low-dose DASE (p = 0.02) was an independent predictor of cardiac events. In contrast, traditional wall motion analysis during DASE provided no additional prognostic information. Conclusions: An increase in MPI at low-dose DASE, reflecting early deterioration of overall left ventricular function, is associated with raised NT-pro-BNP concentration and provides prognostic information beyond conventional stress echocardiographic data after AMI. I nducible myocardial ischaemia may be detected and quantified by dobutamine-atropine stress echocardiography (DASE) after acute myocardial infarction (AMI). The detection of ischaemia is based on semiquantitative wall motion analysis, however, which assesses only left ventricular (LV) systolic function. The Doppler echocardiographic myocardial performance index (MPI) is a quantitative measure of combined LV systolic and diastolic function. [1][2][3] Because impaired LV diastolic function precedes LV systolic dysfunction during myocardial ischaemia, 4 quantitative assessment of changes in both systolic and diastolic LV function seems appealing and may potentially increase the clinical yield of DASE after AMI. Data on the changes in MPI during stress echocardiography are limited. Recently, MPI was found to correlate closely with invasive measures of LV systolic function during b adrenergic stimulation. 5 Furthermore, we have previously shown that MPI consistently improves, decreasing its value, during dobutamine stimulation in healthy people, 6 and MPI has been shown to increase (deteriorate) during dobutamine-induced ischaemia in patients with known or suspected coronary artery disease.

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The myocardial performance index during low-dose dobutamine echocardiography in control subjects and patients with a recent myocardial infarction: a new index of left ventricular functional reserve?

Cited by 10 publications

References 18 publications

Traditional and Color M-Mode Parameters of Left Ventricular Diastolic Function During Low-dose Dobutamine Stress Echocardiography: Relations to Contractility Reserve

Traditional and Color M-Mode Parameters of Left Ventricular Diastolic Function During Low-dose Dobutamine Stress Echocardiography: Relations to Contractility Reserve

Diabetic Cardiomyopathy - Heart Disease in Diabetes

Changes in the Doppler myocardial performance index during dobutamine echocardiography: association with neurohormonal activation and prognosis after acute myocardial infarction

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