Doppler Myocardial Performance Index Research Articles

A STUDY ON ASSESSMENT OF RIGHT VENTRICULAR FUNCTION BY RIGHT VENTRICULAR OUTFLOW TRACT SYSTOLIC EXCURSION IN ADULT POPULATION ATTENDING A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Objectives: The objectives of the study are as follows: (1) to assess the right ventricular function (RVF) by right ventricle outflow tract systolic excursion through M-mode echocardiography and (2) to correlate the right ventricle outflow tract systolic excursion value with other 2D echocardiographic methods of RVF assessment. Methods: The present observational prospective study was conducted in the department of cardiology, Apollo Multispeciality Hospital, Kolkata, among patients visiting the cardiology outpatient department and inpatient department from August 2021 to August 2022 to assess the RVF by right ventricle outflow tract systolic excursion through M-mode echocardiography and correlate the results with other methods (tricuspid annulus plane systolic excursion, tissue Doppler imaging, pulmonary artery pressure, fractional area change [FAC]) of RVF assessment. Results: Majority of the patients in both groups belong to the age group of 51–60 years (45.5%), followed by 61–70 years (29.5%) and 41–50 years (20.5%). Patients with right ventricular (RV) dysfunction were more aged as compared to normal RVF. The mean body mass index (BMI) was significantly higher and mean hemoglobin level was significantly lower in patients with RV dysfunction as compared to the control group (p<0.05). Both systolic and diastolic blood pressures were significantly higher among the patient group than in the control group (p<0.05). We found that right ventricular outflow tract systolic excursion (RVOT-SE), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler myocardial performance index, left ventricular (LV) ejection fraction (%), and FAC were significantly lower among patient group than control group (p<0.01). TAPSE ≤17 mm was the best cutoff value that differentiates patients with RV systolic dysfunction from healthy individuals with normal RV systolic function. There were 67% of patients with ≤17 mm and 33% had >17 mm TAPSE. Conclusion: Our study concludes that RVOT-SE is a highly sensitive and specific method for diagnosing reduced RV systolic function patients. RVOT SE is not accurate as a sole parameter, but its high values can be used as an indicator for normal RV systolic function. It is simple to get, requiring one easy and reproducible M-Mode measurement from the parasternal short-axis view.

TAPSE, Tissue Doppler Systolic annular velocity(S’) and myocardial performance Index (MPI) as a predictor of proximal RCA occlusion in acute inferior wall myocardial ST elevation infarction

TAPSE, Tissue Doppler Systolic annular velocity(S’) and myocardial performance Index (MPI) as a predictor of proximal RCA occlusion in acute inferior wall myocardial ST elevation infarction

Assessment of fetal myocardial performance index in pregnant women with SARS-CoV-2 infection: A prospective cohort study.

Our aim was to investigate the effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on fetal myocardial performance in women who had it during their pregnancy. In our prospective cohort study including healthy pregnant women and pregnant with SARS-CoV-2 infection, we collected patients' data between June 2021 and April 2022. Maternal characteristics, gestational age at SARS-CoV-2 infection and ultrasound examination, and body mass index were noted. Fetal biometry, fetal anatomy scanning, placenta, amniotic fluid index (AFI), and Doppler parameters were routinely examined in all patients. Left ventricular myocardial performance index (MPI) was measured during fetal echocardiography examination. Doppler parameters, AFI, and MPI values were compared between two groups. Compared with the control group (n = 80), MPI values were found within normal limits in fetuses of pregnant women with SARS-CoV-2 infection (n = 80) (MPI: 0.38 ± 0.06 in the control groups vs. 0.39 ± 0.05 in the SARS-COV-2 positive group, p = 0.79). There was no relationship between SARS-CoV-2 infection and changes in AFI and umbilical artery pulsatility index (PI) values. Uterine artery PI values were significantly higher in pregnant women with (SARS-CoV-2) infection (0.81 in the control group vs. 0.97 in the SARS-CoV-2 group, p < 0.05). Fetal cardiac functions were not affected in pregnant women with previous (SARS-CoV-2) infection. Further metaanalyses are warranted to confirm the results.

Can myocardial dysfunction be detected in patients with rheumatoid arthritis with no cardiac symptoms?

The aim of our study was to investigate the role of tissue Doppler and Myocardial Performance Index (MPI) in evaluating cardiac involvement in patients with rheumatoid arthritis (RA) with no cardiac symptoms, to determine whether these measurements differ between healthy controls and RA patients, and whether they can be used to determine the risk of cardiovascular disease and predict prognosis. 50 RA patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA criteria and 50 healthy volunteering controls were included in the study. All patients and controls were assessed using electrocardiography (ECG), echocardiography, conventional Doppler echocardiography and tissue Doppler echocardiography. MPI values were calculated. In addition, RA patients were compared after being divided into two subgroups: seropositive and seronegative RA. Disease activity levels of the patients were determined based on Disease Activity Score in 28 Joints (DAS28). The control group and RA group were compared in terms of PR interval, left atrial diameter, E/A, E/e', and MPI values. Comparisons between the groups yielded statistically significant differences in left atrial diameter, E/A, E/e', and MPI values and no significant difference in PR intervals. These parameters were also compared between seropositive and seronegative patients. Left atrial diameter was significantly higher in seronegative patients than in seropositive patients. There was no significant difference in the other values. DAS28 scores had no correlation with cardiac parameters. Early detection of ventricular dysfunction in RA may be useful in clinical practice when predicting prognosis and optimizing treatment. The present study found that RA patients had impaired tissue Doppler measurements and MPI results compared to controls. MPI and tissue Doppler may be useful in early detection of ventricular dysfunction.

The effect of umbilical cord loops around the fetal neck on the modified Doppler myocardial performance index (Mod- MPI) in a sample of Egyptian population.

The effect of umbilical cord loops around the fetal neck on the modified Doppler myocardial performance index (Mod- MPI) in a sample of Egyptian population.

MORPHOLOGIC CHARACTERISTICS AND FUNCTION OF RIGHT VENTRICLE IN PATIENTS WITH ISOLATED RIGHT BUNDLE BRANCH BLOCK

Background: The prevalence of right bundle branch block (RBBB) is estimated in 0.2 to 1.3% of healthy people. RBBB had independent association with decreased right ventricle (RV) function, which is considered as predictor of adverse cardiovascular outcomes. The aim of this study is to evaluate RV structure and function in patients with isolated RBBB (without structural heart disease) using two-dimensional echocardiography. Methods: A cross-sectional study conducted at Chitwan Medical College, Bharatpur from 1st January 2022 to 30th June 2022. Consecutive adult patients aged ≥18 years with isolated RBBB classified into complete RBBB (CRBBB) and Incomplete RBBB (IRBBB) based on electrocardiographic findings. The echocardiographic evaluation was done to assess RV dimension and function. Results: A total of 52 patients with isolated RBBB were included with mean age of the study population was 45.3 ± 9.3 years, (28 ,53.8%) had CRBBB, whereas the remaining (24, 46.2%) had IRBBB. Among the parameters used to assess RV function; mean RV-Fractional area change (P&lt;0.001), Tricuspid annular plane systolic excursion(P&lt;0.02) and Pulsed Doppler peak velocity at the lateral annulus RV(P&lt;0.001) were significantly lower, while Pulsed Doppler myocardial performance index(P&lt;0.001) was significantly high in CRBBB group as compared to IRBBB group. Similarly, Right atrium and RV dimensional parameters were significant higher in CRBBB compared to IRBBB group. Conclusions: Isolated RBBB is not as benign as it was considered and has deteriorating effect on RV morphology and function. Therefore, patients with Isolated RBBB need follow-up with passing age and more attention toward RV structural and functional analysis.

Fetal echocardiographic evaluation before and after nifedipine treatment in preterm labor.

To assess the effect of nifedipine used for tocolysis on cardiac morphology and functions. The study included 47 pregnant women diagnosed with preterm labor at 32-33weeks. Fetal echocardiographic evaluation was performed with two-dimensional (2D) imaging, M-mode, pulsed wave (PW) Doppler, and tissue Doppler imaging (TDI) before and after the 48th hour of nifedipine treatment. No significant change was observed in Doppler parameters (pulsatility indices of the umbilical artery, middle cerebral artery, ductus venosus) and cardiac morphology (cardiothoracic ratio, end-diastolic longitudinal diameters, sphericity indices, wall thickness) after nifedipine treatment. The parameters obtained with TDI (e', a', s', e'/a', E/e' of mitral and tricuspid valves), M- mode (TAPSE, MAPSE), pulsed Doppler (myocardial performance index, left cardiac output, right cardiac output, tricuspid E, A waves, tricuspid E/A ratio, mitral E, A waves, mitral E/A ratio) did not change after nifedipine treatment. To date, this is the first study to examine the effects of nifedipine on the fetal heart using the TDI. Since nifedipine is a drug that is frequently used and well-tolerated in the prevention of preterm labor, it is crucial that it does not cause changes in fetal cardiac parameters during tocolysis. Therefore, we used TDI in addition to conventional methods to evaluate the effect of nifedipine, which is frequently used in obstetrics, on cardiac functions in the early period. Nifedipine treatment seems not to affect systolic or diastolic functions. This indicates that nifedipine is reliable on cardiac functions and morphology in pregnancies treated for preterm labor.

Left Ventricular Dysfunction Persists in the First Week after Re-Warming following Therapeutic Hypothermia for Hypoxic-Ischaemic Encephalopathy

Objectives: The aim of this study was to assess serial myocardial function in newborn infants receiving therapeutic hypothermia (TH) as treatment for moderate to severe hypoxic-ischaemic encephalopathy (HIE). Methods: Serial echocardiography was performed in 20 term infants receiving TH on days 1–3 and again after re-warming. Left ventricular (LV) fractional shortening, LV cardiac output, and tissue Doppler imaging-derived myocardial velocities and myocardial performance index were measured. Similar assessments were obtained from 20 well term infants within 48 h of birth. Results: LV fractional shortening (LVFS) was similar between cases and controls during all measurements (25.3% vs. 27.4%). The mean LV cardiac output on day 1 was significantly lower in cases (109 mL/kg/min) than in controls (162 mL/kg/min) but increased after re-warming (145 mL/kg/min). All myocardial velocities were significantly lower in cases on day 1, increased during TH, but LV indices remained consistently lower compared to controls even after re-warming. LV myocardial performance index was higher in cases compared to controls on day 1, improved during TH but remained abnormal after re-warming. The right ventricular myocardial performance index was similar between cases and controls. Conclusion: Among infants affected by moderate to severe HIE, LV function appears to be more affected than right ventricular function with LV dysfunction persisting after completion of TH. LVFS was not useful to determine dysfunction in this cohort.

THE EVALUATION OF THE TREATMENT WITH THE EXERCISE TISSUE DOPPLER ECHOCARDIOGRAPHIC PARAMETERS WITH NEBIVOLOL TREATMENT IN PATIENTS WITH HEART FAILURE

Objective: Heart failure is one of the most important disease which threats population’s health. Its prevalance increases both in our country and in the world in years. Nebivolol is a molecule which is proved its efficacy in the treatment of heart failure. The aim of this study was to evaluate the changes in echocardiographic parameters such as tissue doppler imaging and myocardial performance index (MPI) after 6 months of nebivolol treatment in patients with heart failure. Method: 20 patients with heart failure were enrolled to the study The average age was 59.8 ± 8.4 years (15 men, 5 women). During rest and exercise (cycle ergometer) we recorded conventional and tissue doppler parameters. In the first examination we recorded basal measurements. Then nebivolol treatment was administered. After 6 months nebivolol treatment we measured again same echocardiographic parameters. Results: The average Ejection fraction (EF) of patients with heart failure in this study was %38.85 ± 6.45 in the first examination. The average EF was increased to %40.95 ± 5.47 in the end of the study (p<0.05). After 6 months nebivolol treatment both during rest and exercise we found significant improvements in the tissue doppler parameters and MPI. Conclusions: Nebivolol is associated with significant improvements in EF in the patients with heart failure. In addition, both during rest and exercise, it’s associated with improvements in tissue doppler parameters which can show beneficial effect on the prognosis of this group of patients.

Assessments of left ventricular systolic and diastolic functions with tissue Doppler imaging and myocardial performance index in children with chronic kidney disease.

This study aimed to document early left ventricular (LV) dysfunction in chronic kidney disease (CKD) using methods such as tissue Doppler imaging and the myocardial performance index (MPI). A total of 40 patients diagnosed with CKD (mean age, 10.1 ± 4.1 years) and 40 sex- and age-matched healthy controls (mean age, 9.6 ± 4.3 years) were examined. In the patient group, 20 patients had early stage (Stage 2-3) CKD and 20 patients had late-stage (stage 4-5) CKD, and 18 patients had hypertension. The pulmonary artery systolic pressure (PAPs) and LV mass index (LVMI) were significantly higher in the patient group (P < 0.05). The LV septal and lateral margins of the mitral annulus E'/A' ratio, E/E' ratio and MPI results were significantly different between the groups (P < 0.05). The MPI scores were higher in late-stage CKD than in early stage CKD (P < 0.05). The E'/A' ratio was lower and the MPI was higher in the hypertensive CKD group compared with the normotensive CKD group (P < 0.05). The E/E' ratio was correlated positively with the LVMI, and the PAPs, and negatively with glomerular filtration rate, S' value, E'/A' ratio. The MPI was correlated positively with blood pressure, LVMI, PAPs, and the S value, and negatively with the E'/A' ratio. The E'/A' ratio, the E/E' ratio, and the isovolumetric relaxation time measured by tissue Doppler imaging is highly accurate and easily applicable for detecting diastolic LV function, and the MPI is suitable for detecting both systolic and diastolic LV dysfunction. Their routine use may be useful in evaluating LV functions in children with CKD.

RETRACTED: Normal reference ranges for fetal cardiac function: Assessed by modified Doppler myocardial performance index (Mod MPI) in the Egyptian population

To develop gestational age-based reference ranges for the modified Doppler myocardial performance index (Mod MPI) and to examine the maternal characteristics that affect this measurement. This was a cross-sectional study, comprised of 1021 healthy pregnancies between 20+0 to 35+6 weeks' gestation. They were all undergoing ultrasound examination in Cairo Fetal Medicine Unit (CAIFM) in Cairo University, Egypt from 1st April 2017 till 1st April 2019. Mod MPI was obtained used method described by Friedman et al. (2003). Median and SD models were fitted between Mod MPI and gestational age. The distributions of Mod MPI Z-scores were examined in relation to maternal characteristics RESULTS: The normal Mod MPI in second and third trimester (20 + 1 to 35 + 6 weeks' gestation) was 0.408 ± 0.08. Mod MPI was not affected by maternal age, body mass index (BMI) or parity (p value 0.5, 0.6 and 0.2 respectively). This study established normal reference ranges for Mod MPI according to gestational age and generated a graph with 5th,10th, 90th and 95th centiles. Maternal characteristics as age, BMI or parity do not affect value of Mod MPI.

Assessment of right ventricular function using right ventricular outflow tract-systolic excursion in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis

Background There are inadequate studies validating the efficacy of several echocardiographic parameters of right ventricular (RV) function in assessing RV infarction and predicting stenosis of proximal right coronary artery (RCA). Most of them evaluated a single parameter and many lacked angiographic correlations.Aim To evaluate RV systolic function using systolic excursion of right ventricular outflow tract (RVOT-SE) by echocardiography with correlation to stenosis of proximal RCA in patients with first incident of acute inferior wall myocardial infarction.Patients and methods Parasternal short-axis view at the level of the aortic valve was obtained using M-mode echocardiography, and RVOT-SE was defined as the RVOT-SE anterior wall. It was measured in 50 patients who underwent CA after acute Inferior ST elevaion myocardial (STEMI).Results Patients with reduced RV function were identified with tricuspid annular plane systolic excursion (TAPSE) below 16 mm. RVOT-SE optimal cutoff values to predict RV systolic dysfunction was SE=5.4 mm with a sensitivity of 91.7% and specificity of 99.97% (area under the curve=0.935, P=0.00). RVOT-SE prediction of proximal RCA stenosis was with a sensitivity of 91.4% and specificity of 90.2%. The study showed significant positive correlations with RV-fractional area change and TAPSE (P=0.00) and significant negative correlations with tissue Doppler myocardial performance index and pulsed wave myocardial performance index (P=0.00).Conclusion RVOT-SE is a naive and precise method for assessing RV systolic function. This study suggested the use of RVOT-SE as a parameter of RV function paired with other indices such as TAPSE.

Akut iskemik inmeli hastalarda miyokard fonksiyonunun doku Doppler miyokardiyal performans indeksi ile değerlendirilmesi

Purpose: The aim of this study is to investigate the relationship between myocardial function assessed by tissue Doppler imaging myocardial performance index (TDI-MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 128 patients (males, 55; females, 73; 68 ± 19 years) with acute ischemic stroke. 20 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score &amp;lt; 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit.Results: There were no significant differences among demographic parameters of patients. Tissue Doppler myocardial performance index was significantly higher in Group 2 patients than in Group 1 patients (0.62±0.28 vs 0.46±0.16).Conclusion: Our results suggest that TDI-MPI is associated with stroke severity on admission in patients with acute ischemic stroke. TDI-MPI is an indicator of global myocardial dysfunction with a different from LVEF. TDI-MPI, which includes both systolic and diastolic time intervals to assess the global cardiac dysfunction.

Fetal Myocardial Performance Index in the Third Trimester of Pregnancy: Feasibility and Reproducibility of Conventional Spectral Doppler versus Spectral Tissue Doppler Technique.

This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population. This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks' gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients. Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (68/79, 86% vs. 42/79, 53.2%), p-value <0.01. In obese subjects (n = 50) LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (37/50, 74% vs. 26/50, 52%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (40/50, 80% vs. 25/50, 50%), p-value <0.01. intraclass correlation coefficient for all modalities ranged between 0.73 and 0.93, except for LV conventional spectral Doppler intraobserver variability which was 0.22. Tissue Doppler had statistically higher completion rates than conventional spectral Doppler, including the obese subgroup, with evidence of strong reproducibility in the third trimester.

Reference ranges for left, right and interventricular septum indices at 20 to 36+6 weeks of gestation derived using spectral myocardial tissue Doppler on Voluson ultrasound machines.

To establish reference range values for peak myocardial tissue Doppler velocity (MTD) and myocardial performance index (MPI) of the left ventricle (LV), the right ventricle (RV), and the interventricular septum (IVS) at 20 to 36+6 weeks of gestation using spectral tissue Doppler. This cross-sectional study was conducted among 360 lowrisk singleton pregnancies. MTD during systole (S'), and early (E') and late diastole (A'), and MPI' were assessed by placing sample volume at the basal segment of the LV free wall, the RV free wall, and the IVS, respectively. Polynomial regression was used to obtain the best-fit curves for MTD and MPI' measurements as a function of gestational age (GA), and adjustments were made using the determination coefficient (R2). Intra- and inter-observer reproducibility was evaluated using the concordance correlation coefficient (CCC). All MTD velocities (cm/s) progressively increased with advancing GA (p<0.0001). Mean LV MTD values were 4.19 to 6.86 for S', 3.52 to 7.22 for E', and 6.85 to 9.19 for A'; mean RV MTD were 4.85 to 7.97 for S', 4.49 to 8.66 for E', and 8.44 to 11.20 for A'; and mean IVS MTD values were 3.75 to 5.78 for S', 3.34 to 5.79 for E', and 5.88 to 7.98 for A'. LV MPI', RV MPI', and IVS MPI' did not significantly change with advancing GA. The CCC values for MTD were predominantly greater than 0.70, while those for MPI' were <0.70. Reference values for the fetal MTD and MPI' of RV, LV and IVS using tissue Doppler between 20 and 36+6 weeks of gestation were described.

Early detection of left ventricular involvement in patients with Duchenne’s and Becker’s muscular dystrophy

Background Patients with Duchenne muscular dystrophy (DMD) and Becker’s muscular dystrophy (BMD) may have asymptomatic cardiac involvement for years before the development of dilated cardiomyopathy and even showed normal conventional echocardiographic parameters. We evaluated those patients with more recent echo modalities for early detection of subtle cardiac changes. Patients and methods Thirty patients [13 with BMD as group 1 (G1) and 17 with DMD as group 2 (G2)] compared with 30 age-matched and sex-matched healthy participants as group 3 (G3). All cases were subjected to history taking, clinical examination, ECG, conventional two-dimensional (2D) echocardiography, tissue Doppler imaging, 2D-speckle tracking echocardiography, and 4D echocardiography for measurement of left ventricular (LV) dimensions, systolic and diastolic function with focus on strain imaging modality. Results Nine patients of G2 and three patients in G1 had LV systolic dysfunction despite normal 2D-LV ejection fraction. Ten patients in G2 and five patients in G1 had LV diastolic dysfunction measured by LV early diastolic wave velocity over mitral valve measured by conventional Doppler/early diastolic mitral annular velocity by tissue Doppler imaging (E/Ea). Tissue Doppler myocardial performance index was significantly higher in both G1 and G2. 2D-LV septal strain, lateral strain, anteroseptal, 2D-global longitudinal strain (GLS), and 4D-GLS strains were significantly lower in G1 and G2. Apical, mid, and basal posterior LV strain were significantly lower in G2 compared with G1. 2D-GLS was lower in G2 compared with G1. Both LV global radial strain and global circumferential strain were significantly lower in G1 and G2. Mid and basal septal strain and basal posterior strain were significantly lower in G2 compared with G1. The mid and basal posterior strains were significantly lower in G2 compared with G1. Conclusion 2D-speckle tracking and 4D echocardiographic study of global and regional strain besides creatinine phosphokinase serum levels may add benefit in early detection of subtle LV dysfunction in patients with DMD and BMD.

Kronik böbrek yetersizliği olan çocuklarda hemodiyalizin kardiyak etkileri

Purpose: The aim of the study was to evaluate cardiac functions before and after hemodialysis in children with chronical renal failure.Materials and Methods: The study comprised 24 children undergoing hemodialysis more then six months. Conventional and tissue Doppler echocardiography was performed, NT-proBNP levels were measured before and after hemodialysis. Echocardiographic results were compared regard to hydration status which measured with body composition monitor and hypotension event during dialysis. Results: Myocardial performance indices which gained with tissue Doppler echo were high in 22 patient. Mitral E/A ratio significantly decreased after hemodialysis. NT-proBNP levels were high but no difference was determined after dialysis. Nine patient experienced hypotension but nonsignificant difference was detected regarding echocardiographic findings and NT-proBNP levels. Conclusion: Diastolic dysfunction is frequent in chronical renal failure. Tissue Doppler echocardiography and myocardial performance index supply a more proper evaluation of global and regional cardiac function in chronical renal failure due to less hydration affectability. NT-proBNP should be monitored for cardiac dysfunction in chronical renal failure. Body composition monitor should be used in children for setting the ultrafiltration volume.

Fetal kalp fonksiyonlarının değerlendirilmesinde konvansiyonel Doppler miyokardiyal performans indeksi, triküspid ve mitral kapak anüler düzlem sistolik hareketleri

Fetal kalp fonksiyonlarının değerlendirilmesinde konvansiyonel Doppler miyokardiyal performans indeksi, triküspid ve mitral kapak anüler düzlem sistolik hareketleri

Doppler myocardial performance index combined with plasma B-type natriuretic peptide levels as a marker of cardiac function in patients with decompensated cirrhosis.

Background:In chronic liver diseases, cirrhosis ranks as the 14th highest death cause worldwide, developing into decompensated cirrhosis. A potential and feasible technique in assessing cardiac function is urgent. This study explores if the Doppler myocardial performance (Tei) index combined with the plasma B-type natriuretic peptide (BNP) levels can assess cardiac function in patients with decompensated cirrhosis.Methods:A total of 140 individuals were selected in the study and were classified into 3 groups: control group (n = 40, healthy individuals), compensated cirrhosis group (n = 50), and decompensated cirrhosis group (n = 50). Plasma BNP levels, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and albumin (ALB) were identified by an enzyme-linked immunosorbent assay (ELISA). The correlation of Tei index between left ventricle (LV) and right ventricle (RV) as well as plasma BNP levels with cardiac function was assessed using a Pearson test analysis. All patients were subjected to this experiment for 1 year to analyze the relationship between Tei index and plasma BNP levels in prognosis of decompensated cirrhosis patients.Results:Patients with decompensated cirrhosis showed significantly elevated levels of ALT, AST, and TBIL level in contrary to a reduced ALB level. Cirrhosis patients also showed a significantly reduced ejection fraction (ET) index, but an increase in isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), Tei index, and plasma BNP levels in comparison to healthy individuals. ICT, IRT, Tei index, and plasma BNP levels were elevated in decompensated cirrhotic patients as opposed to compensated cirrhotic patients. These results indicate a positive correlation of both Tei index and plasma BNP levels with cirrhosis and its progression. Tei index and plasma BNP levels are positively associated with Child–Pugh classification and negatively correlated with both cardiac function and prognosis in patients suffering from decompensated cirrhosis.Conclusion:The study provided evidence supporting the correlation of Tei index and plasma BNP levels in decompensated cirrhotic patients with cardiac function, highlighting a potential value for evaluation.

Echocardiographic Measurements of Right Ventricular Mechanics in Infants with Bronchopulmonary Dysplasia at 36 Weeks Postmenstrual Age

To test the hypothesis that specific echocardiographic measurements of right ventricular (RV) mechanics at 36 weeks postmenstrual age (PMA) are associated with the severity of bronchopulmonary dysplasia (BPD). A subset of 93 preterm infants (born between 27 and 29 weeks of gestation) was selected retrospectively from a prospectively enrolled cohort. BPD was defined using the National Institutes of Health workshop definition, with modifications for oxygen reduction testing and altitude. The cohort was divided into no-BPD and BPD groups using previously published methodology for analyses. Echocardiographic measurements of RV function (ie, tricuspid annular plane systolic excursion, fractional area of change, systolic-to-diastolic ratio, tissue Doppler myocardial performance index, and RV strain), RV remodeling/morphology (end-systolic left ventricular eccentricity index), and RV afterload (pulmonary artery acceleration time measure) were evaluated at 36 weeks PMA. Multivariable logistic regression determined associations between RV measurements and BPD severity. Compared with the no-BPD cohort, the BPD group had lower birth weight z-scores (P = .04) and trended toward a male predominance (P = .08). After adjusting for birth weight z-score, gestational age, and sex, there were no between-group differences in echocardiographic measurements except for the eccentricity index (scaled OR [0.1-unit increase], 1.49; 95% CI, 1.13-2.12; P = .01). Among conventional and emerging echocardiographic measurements of RV mechanics, eccentricity index was the sole variable independently associated with BPD severity in this study. The eccentricity index may be a useful echocardiographic measurement for characterizing RV mechanics in patients with BPD at 36 weeks PMA.