Abstract
Doppler‐derived myocardial performance index (MPI) has been described as a noninvasive measurement of LV function. Our aim was to investigate the effect of hemodialysis related volume reduction and heart rate changes on the Doppler‐derived LV MPI, and Doppler tissue imaging (DTI) derived left and right ventricular MPI.
Method:
The study group comprised 32 consecutive patients (mean age: 43 ± 18 yrs) undergoing hemodialysis. Patients underwent echocardiography before and immediately after hemodialysis session. Left and right ventricular MPI derived from conventional pulsed‐wave Doppler and DTI was calculated. The difference in MPI, heart rate and body weight was calculated before and after hemodialysis.
Results:
Doppler‐derived LV MPI, and right ventricular MPI obtained by DTI were increased (p = 0.05) but the LV MPI obtained by DTI was unchanged after hemodialysis. There is a significant positive correlation between the Doppler‐derived LV MPI difference and volume reduction (r = 0.38, p = 0.032). The heart rate difference was correlated with Doppler‐derived LV MPI difference, and DTI derived right ventricular MPI difference (r = 0.38, p = 0.034; r = 0.48, p = 0.006, respectively). Whereas, DTI derived LV MPI difference was not correlated with heart rate difference. By the multivariate analysis, there was no correlation between Doppler‐derived LV MPI difference with heart rate difference, and volume reduction. Right ventricular MPI difference correlated with heart rate difference (r = 0.41, p = 0.021) but not with volume reduction. Doppler‐derived MPI is partially influenced by preload and heart rate changes. However, DTI derived LV MPI is not influenced by preload and heart rate changes. Copyright © 2007 Wiley Periodicals, Inc.
Keywords: doppler tissue imaging, heart rate changes, myocardial performance index, volume reduction
Full Text
The Full Text of this article is available as a PDF (655.3 KB).
References
- 1. Xie GY, Berk MR, Smith MD, Gurley JC, DeMaria AN: Prognostic value of Doppler transmitral flow patterns in patients with congestive heart failure. J Am Coll Cardiol 1994; 24: 132–139. [DOI] [PubMed] [Google Scholar]
- 2. Xie GY, Berk MR, Smith MD, DeMaria AN: Relation of Doppler transmitral flow patterns to functional status in congestive heart failure. Am Heart J 1996; 131: 766–771. [DOI] [PubMed] [Google Scholar]
- 3. Pinamonti B, Di Lenarda A, Sinagra G, Camerini F: Restrictive left ventricular filling pattern in dilated cardiomyopathy assessed by Doppler echocardiography: clinical, echocardiographic and hemodynamic correlations and prognostic implications. J Am Coll Cardiol 1993; 22: 808–815. [DOI] [PubMed] [Google Scholar]
- 4. Little WC: Assessment of normal and abnormal cardiac function In Heart Disease: a Textbook of Cardiovascular Medicine (6th ed.) (Eds. Braunwald E, Zipes DP, Libby P.), pp 479–502. Philadelphia, CA: WB Saunders Company, 2001. [Google Scholar]
- 5. Nishimura RA, Abel MD, Hatle LK, Tajik AJ: Relation of pulmonary vein to mitral flow velocities by transesophageal Doppler echocardiography. Effect of different loading conditions. Circulation 1990; 81: 1488–1497. [DOI] [PubMed] [Google Scholar]
- 6. Hurrell DG, Nishimura RA, Ilstrup DM, Appleton CP: Utility of preload alteration in assessment of left ventricular filling pressure by Doppler echocardiography: a simultaneous catheterization and Doppler echocardiographic study. J Am Coll Cardiol 1997; 30: 459–467. [DOI] [PubMed] [Google Scholar]
- 7. Downes TR, Nomeir AM, Stewart K, Mumma M, Kerensky R, et al.: Effect of alteration in loading conditions on both normal and abnormal patterns of left ventricular filling in healthy individuals. Am J Cardiol 1990; 65: 377–382. [DOI] [PubMed] [Google Scholar]
- 8. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, et al.: New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function: a study in normal and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366. [PubMed] [Google Scholar]
- 9. Eidem BW, Tei C, O'Leary PW, Cetta F, Seward JB: Nongeometric quantitative assessment of right and left ventricular function: myocardial performance index in normal children and patients with Ebstein anomaly. J Am Soc Echocardiogr 1998; 11: 849–856. [DOI] [PubMed] [Google Scholar]
- 10. Tei C, Dujardin KS, Hodge DO, Bailey KR, McGoon MD, et al.: Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr 1996; 9: 838–847. [DOI] [PubMed] [Google Scholar]
- 11. Ozdemir K, Altunkeser BB, Icli A, Ozdil H, Gok H: New parameters in identification of right ventricular myocardial infarction and proximal right coronary artery lesion. Chest 2003; 124: 219–226. [DOI] [PubMed] [Google Scholar]
- 12. Møller JE, Poulsen SH, Egstrup K: Effect of preload alternations on a new Doppler echocardiographic index of combined systolic and diastolic performance. J Am Soc Echocardiogr 1999; 135: 1065–1072. [DOI] [PubMed] [Google Scholar]
- 13. Lax JA, Bermann AM, Cianciulli TF, Morita LA, Masoli O, et al.: Estimation of the ejection fraction in patients with myocardial infarction obtained from the combined index of systolic and diastolic left ventricular function: a new method. J Am Soc Echocardiogr 2000; 13: 116–123. [DOI] [PubMed] [Google Scholar]
- 14. Tei C, Dujardin KS, Hodge DO, Kyle RA, Tajik AJ, et al.: Doppler index combining systolic and diastolic myocardial performance: a clinical value in cardiac amyloidosis. J Am Coll Cardiol 1996; 28: 658–664. [DOI] [PubMed] [Google Scholar]
- 15. Yeo TC, Dujardin KS, Tei C, Mahoney DW, McGoon MD, et al.: Value of a Doppler‐derived index combining systolic and diastolic time intervals in predicting outcome in primary pulmonary hypertension. Am J Cardiol 1998; 81: 1157–1161. [DOI] [PubMed] [Google Scholar]
- 16. Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, et al.: Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic dilated cardiomyopathy. Am J Cardiol 1998; 82: 1071–1076. [DOI] [PubMed] [Google Scholar]
- 17. Eidem BW, O'Leary PW, Tei C, Seward JB: Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease. Am J Cardiol 2000; 86: 654–658. [DOI] [PubMed] [Google Scholar]
- 18. Bornstein A, Gaasch WH, Harrington J: Assessment of the cardiac effects of hemodialysis with systolic time intervals and echocardiography. Am J Cardiol 1983; 51: 332–335. [DOI] [PubMed] [Google Scholar]
- 19. Bornstein A, Zambrano SS, Morrison RS, Spodick DH: Cardiac effects of hemodialysis: noninvasive monitoring by systolic time intervals. Am J Med Sci 1975; 269: 189–192. [DOI] [PubMed] [Google Scholar]
- 20. Fragata J, Areias JC: Effects of gradual volume loading on left ventricular diastolic function in dogs: implications for optimization of cardiac output. Heart 1996; 75: 352–357. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Poulsen SH, Nielsen JC, Anderson HR: The influence of heart rate on the Doppler‐derived myocardial performance index. J Am Soc Echocardiogr 2000; 13: 379–384. [DOI] [PubMed] [Google Scholar]
- 22. Lavine SJ: Effect of heart rate and preload on index of myocardial performance in the normal and abnormal left ventricle. J Am Soc Echocardiogr 2005; 18: 133–141. [DOI] [PubMed] [Google Scholar]
- 23. Lutz JT, Giebler R, Peters J: The Tei index is preload dependent and can be measured by transesophageal echocardiography during mechanical ventilation. Eur J Anaesthesiol 2003; 20: 872–877. [DOI] [PubMed] [Google Scholar]
- 24. Cheung MM, Smallhorn JF, Redington AN, Vogel M: The effects of changes in loading conditions and modulation of inotropic state on the myocardial performance index: comparison with conductance catheter measurements. Eur Heart J 2004; 25: 2238–2242. [DOI] [PubMed] [Google Scholar]
