Abstract 20799: Assessment of Heart Failure With Preserved Ejection Fraction: An Application of Tissue Doppler Imaging-Derived Myocardial Performance Index
Background: In heart failure with preserved ejection fraction (HFPEF), physiological abnormalities are not solely restricted to diastole with systolic function not being completely preserved. Because tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) offers the advantage of recording systolic and diastolic tissue velocity simultaneously in the same cardiac cycle, this study was aimed at determining whether TDI-MPI is an informative index for the assessment of HFPEF compared to conventional echocardiographic parameters.
Methods: Among one-seventy nine patients of HFPEF and 49 age-matched healthy controls, cardiac function was evaluated by conventional echocardiography, TDI-velocity and -MPI. In the patients with HFPEF, during the median follow-up of 32 months, clinical outcomes, defined as the composite of cardiovascular death and readmission for HF, were assessed.
Results: Mean TDI-MPI was significantly greater in HFPEF group compared with healthy control (0.64 ± 0.26 vs. 0.33 ± 0.07, p < 0.001), and it had a significant correlation with NT-ProBNP level (r = 0.583, p < 0.001). The area under ROC curve of TDI-MPI for detection of HFPEF was 0.97, and a TDI-MPI of 0.39 was determined to be an optimal cut-off value (sensitivity 98.9%, specificity 89.8%). With regard to clinical outcomes in 179 patients with HFPEF, 32 clinical events including 1 cardiac death and 31 HFs were identified during their follow-up periods. On a multivariate analysis, TDI-MPI remained an independent prognostic predictor of cardiac events (HR 1.9, CI 1.1–3.5; p = 0.035).
Conclusions: TDI-MPI may be an independent parameter for evaluation and predicting clinical outcomes of HFPEF.
- © 2010 by American Heart Association, Inc.