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

Abstract

Background: Echocardiographic evaluation of left ventricular ejection fraction (LVEF) is used in the risk stratification of patients with an acute myocardial infarction (AMI). However, the prognostic value of the Tei index, an alternative measure of global cardiac function, in AMI patients is not well established. Methods: We conducted a systematic review, using MEDLINE and EMBASE, to evaluate the prognostic value of the Tei index in predicting adverse outcomes in patients presenting with AMI. The data was collected and narratively synthesized. Results: A total of 16 studies were including in this review with 2886 participants (mean age was 60 years from 14 studies, proportion of male patients 69.8% from 14 studies). Patient follow-up duration ranged from during the AMI hospitalisation stay to 57.8 months. Tei index showed a significant association with heart failure episodes, re-infarction, death and left ventricular thrombus formation in 14 out of the 16 studies. However, in one of these studies, Tei index was only significantly predictive of cardiac events in patients where LVEF was <40%. In two further studies, Tei index was not associated with predicting adverse outcomes once LVEF, left ventricular end systolic volume index and left ventricular early filling time was taken into consideration. In the two remaining studies, there was no prognostic value of Tei index in relation to patient outcomes. Conclusions: Tei index may be an important prognostic marker in AMI patients however more studies are needed to better understand when it should be used routinely within clinical practice.

Tei Index Is a Useful Adjunctive Tool in the Diagnostic Workup of Patients with Acute Myocarditis

“…In previous studies, the TI was identified as a sensitive tool for diagnosis and risk stratification of patients with heart failure [ 16 , 23 , 24 ], chronic coronary syndrome [ 19 ] and acute myocardial infarction [ 25 , 26 ]. However, despite the promising findings of previous studies, evidence on the clinical aspects of the TI in myocarditis is very scarce.…”

Independent Predictors of Adverse Cardiovascular Events in Patients With CHF of Ischemic Origin

“…At the same time, Rahman N. and co-authors (2009) showed that the TEI index value > 0.40 had better sensitivity (86% vs. 65%), specificity (82% vs. 50%) and accuracy (83% vs. 58%) compared with LV EF <40% to predict cardiac complications, including cardiogenic shock, revascularization, rehospitalization, congestive heart failure, and atrioventricular block [11].…”

“…Souza L.P. et al (2011) found that LV EF ≤45% was associated with an increased chance of heart failure progression, but only among patients ≥ 60 years of age with a TEI index ≥ 0.57. Biering Sørensen T. et al (2013) reported that TEI index values greater than (0.59 ± 0.16 vs. 0.52 ± 0.13, P <0.001) was associated with major adverse events, including congestive heart failure, myocardial infarction, and mortality [11].…”

Role of Electromechanical Dyssynchrony Assessment During Acute Circulatory Failure and Its Relation to Ventriculo-Arterial Coupling

“…Several echocardiographic time intervals and parameters are associated with cardiac performance, thus with clinical outcomes (13)(14)(15)(16)). Tei's index, which is defined as the sum of isovolumic contraction time and relaxation time divided by the ejection time, is described as an index of global myocardial performance and as a prognostic factor in patients presenting with acute myocardial infarction (17). The isovolumic time/heterovolumic time ratio (I/H) index, which is defined as the sum of isovolumic relaxation and contraction time divided by the sum of ejection and filling time, has also been considered a potential indicator of myocardial time yield and efficiency (18).…”