Myocardial Performance Index Index Research Articles

Assessment of myocardial performance index in late-onset fetal growth restriction.

ABSTRACTThe aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3rd and 3rd – 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3rd and 3rd – 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.

Left Ventricular Myocardial Performance Index and Its Relationship with Presystolic Wave in Prediabetic Patients

Introduction: In this study, we aimed to investigate the effect of prediabetes on the cardiovascular system and the relationship between MPI and PSW by using myocardial performance index (MPI) and presystolic wave (PSW) and the usability of both parameters as a screening test. Methods: A total of 113 participants, that is, 59 prediabetic patients and 54 healthy volunteers, aged 18–79 years, who applied to cardiology and endocrinology polyclinics between March 2020 and September 2020, were included in the present study. The groups were compared in demographic and clinical data, left ventricular functions, left ventricular MPI, PSW, and laboratory results. Results: Left ventricular diastolic dysfunction (p=0.001), MPI (p<0.001), and PSW (p=0.003) were higher in the prediabetic group. A positive correlation was observed between fasting blood glucose and MPI index (r=0.509, p<0.001) and between PSW and MPI (r=0.405, p=0.001). Discussion and Conclusion: This study is the first in the literature to examine the effects of prediabetes on the cardiovascular system using MPI and PSW. We think that these parameters may be associated with left ventricular diastolic dysfunction in prediabetics.

Echocardiographic evaluation of cardiac functions in newborns of mildly preeclamptic pregnant women within postnatal 24–48 hours

The aim of this study is to detect preeclampsia-related cardiac dysfunction within 24–48 hours of delivery in newborns born from preeclamptic mothers. Forty newborns from mildly preeclamptic mothers formed the study group and the control group was formed by 40 healthy newborns. Cardiac function for the groups were evaluated using conventional echocardiography and myocardial performance index (MPI) within the first 24–48 hours of their lifetime and the results of both groups were compared. A significant difference between the groups was observed especially in the PW Doppler MPI measurements (the left ventricle MPI 0.37 ± 0.09 and 0.26 ± 0.11, p < .001; the right ventricle MPI 0.29 ± 0.08 and 0.26 ± 0.07, p < .035) for the control group and the study group. Elongation in the left and right ventricle MPI was detected to be more significant in terms of comparing systolic and diastolic functions to determine preeclampsia-related cardiac injury in newborns from preeclamptic mothers within the first 24–48 hours of their lifetime.Impact statementToday, the methods which may detect cardiac injury earlier than conventional echocardiographic methods are used for evaluating cardiac functions. Among them, myocardial performance index (MPI) measurement with PW Doppler is the most common ones.While studies are available in the literature evaluating foetal cardiac functions with MPI in foetuses of preeclamptic women, studies evaluating cardiac functions with MPI index within the first 24–48 hours in postnatal period are not available. This is the first study to detect cardiac injury by measuring cardiac functions of the newborns of preeclamptic babies using conventional echocardiography (EF, SF, mitral and tricuspid E/A) and myocardial performance index within the first 24–48 hours of life and compare these values with those of a control group composed of healthy newborns with similar demographic characteristics.According to the results of the study, elongation in right and left ventricle MPI was detected to be more significant compared to systolic and diastolic functions for determining preeclampsia-related cardiac injury in newborns of preeclamptic mothers within 24–48 hours of delivery. Ventricle functions of the newborns of preeclamptic mothers should also be evaluated with MPI measurement besides conventional echocardiographic measurements.

Left &amp; Right Ventricular Myocardial Performance Index and it’s Relation with TIMI Frame Count in the Coronary Slow Flow Phenomenon

Aim: To investigate the left and right ventricular myocardial performance index in patients with coronary slow flow phenomenon and to determine the relationship between it and thrombolysis in myocardial infarction frame count in SCF patients. Material and methods: 45 patients with slow coronary flow; mean age 51 ± 12 years and 20 subjects with angiographically normal coronary; mean age 52 ± 12 years, were included in the study. All the subjects underwent echocardiography and tissue Doppler imaging to determine left & right ventricular diastolic functions and myocardial performance index (MPI). Results: The TDE parameters obtained from the left and right ventricles showed. LV Sm, and Am, was similar in both the SCF and control groups; however, LV Em, Em/Am, IRT and MPI were significantly different in the SCF group compared to the control. RV wall Sm, and Am were similar in both the SCF and control groups however, RV Em, Em/Am, IRT and MPI were significantly different in the SCF group compared to the control. Patients had significantly higher TFC for each major epicardial coronary artery (P < 0.001). TFC was positively correlated with the left ventricle MPI index (r = 0.61, p < 0.001), the right ventricle MPI index (r = 0.49, p < 0.001), and mitral IVRT (r = 0.61, p < 0.001). There was a strong inverse correlation between mean TFC and left ventricle Ea and Ea/Aa ratio (r = -0.70, p < 0.001; r = -0.45, p = 0.001, respectively). Conclusion: Left and right ventricular diastolic functions deteriorated in the CSF phenomenon and this deterioration was associated with increased TIMI frame count.

Fetal myocardial index during labor

Abstract BACKGROUND: The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool and can be used to evaluate systolic and diastolic function in fetuses. The objectives of this study were to investigate the MPI during labor and compare it to values in non-laboring women. METHODOLOGY: 40 women with uncomplicated, term, singleton pregnancies were recruited to this prospective observational study at Thomas Jefferson University Hospital. Controls were a retrospective cohort of women &gt; 34 weeks who underwent third trimester fetal echocardiography. Fetal left and right sided isovolumic contraction time, isovolumic relaxation time and ejection time were recorded before, during and after contractions. Right and left sided MPI was then calculated. RESULTS: Laboring patients and non-laboring patients were comparable for age, race, gravidity and parity. During labor the average left MPI was 0.63 ± 0.17 and the average right MPI was 0.62 ± 0.20. The coefficient of correlation between MPI and cervical dilation was 0.15 for left MPI Index and 0.14 for right MPI. When comparing non-laboring to laboring women, the average left MPI for non-laboring women was 0.34 ± 0.04, p = &lt;0.001. CONCLUSIONS: Myocardial Performance Index is a non-invasive, easily attainable measure of cardiac function that can be obtained during labor and does not change with cervical dilation. MPI is significantly different between laboring and non-laboring women. The fetal MPI may help define fetal status in labor.

Right ventricular function and its relationship with grade of hepatosteatosis in non-alcoholic fatty liver disease.

SummaryObjectiveThis study was designed to assess right ventricular systolic and diastolic function and its relationship with grade of hepatosteatosis (HS) in non-alcoholic fatty liver disease (NAFLD) patients using conventional and tissue Doppler echocardiography.MethodsNAFLD was diagnosed in 32 individuals (15 males, 17 females; 59% were grade I HS, 41% grade II–III HS) by means of ultrasonography. Twenty-two individuals, whose ultrasonography data did not show HS, comprised the control group (11 males, 11 females) and were included in the study. Right ventricular systolic and diastolic function and their relationship with grade of HS were assessed by conventional and tissue Doppler echocardiography. Additionally, right ventricular global function was assessed by myocardial performance index (MPI).ResultsWhen compared by conventional echocardiographic parameters, there were no significant differences between the two groups. With tissue Doppler parameters, the tricuspid annulus peak early diastolic velocity and ratio of early-tolate diastolic velocity were lower in the patients than in the controls (p = 0.03, p = 0.02, respectively). The isovolumetric relaxation time and MPI were significantly higher (p < 0.001, p < 0.001, respectively) in the patient group. HS grade was positively correlated with right ventricular isovolumetric relaxation time and MPI index (r = 0.295, p = 0.03, r = 0.641, p < 0.001, respectively).ConclusionThese results show that right ventricular diastolic dysfunction (RVDD) in patients with NAFLD and degree of HS was associated with RVDD.

2082399 Fetal Myocardial Performance Index During Progression of Labor

The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool. It has been used in perinatology to evaluate systolic and diastolic dysfunction in fetuses with twin to twin transfusion syndrome and intrauterine growth restriction. The OBJECTIVES: of the study was to investigate the MPI during labor of normal term pregnancies, to establish normative values, and to evaluate change with cervical dilation. Women with uncomplicated, term, singleton pregnancies were recruited to this prospective observational study at Thomas Jefferson University Hospital. Exclusion criteria were multiples, fetal anomalies, preterm labor, non-cephalic presentation. Participants underwent an ultrasound examination by one sonographer, during which fetal left and right sided isovolumic contraction time (ICT), isovolumic relaxation time (IRT) and ejection time(ET) were recorded before, during and after contractions. Right and left sided MPI were then calculated using the formula MPI = (ICT+IRT)/ET. MPI was measured before, during and after uterine contractions. The MPI was calculated using an average of three measurements of ICT, IRT and ET. Statistical analysis was performed with student t-test, and X2 as appropriate. A p value of <0.05 was considered statistically significant. 20 patients were recruited. On average, patients were 29.2 ± 5.7 years old, in their 4th pregnancy, with a BMI of 32.9 ± 5.0 at delivery. The average left MPI during labor in term fetuses was 0.34 ± 0.04. The average right MPI during labor was 0.22 ± 0.07. There was no difference in Left or Right MPI based on contraction timing (p= 0.82, p= 0.80). The coefficient of correlation (R value) between MPI and cervical dilation was 0.15 for Left MPI Index and 0.09 for Right MPI. Myocardial Performance Index is a non-invasive, easily attainable measure of cardiac function that can be obtained during labor and does not change with labor. The fetal MPI may help define fetal status in labor.

Is MRI the Preferred Method for Evaluating Right Ventricular Size and Function in Patients With Congenital Heart Disease?

Is MRI the Preferred Method for Evaluating Right Ventricular Size and Function in Patients With Congenital Heart Disease?

Left Ventricular Functions and Its Relation with Grade of Hepatosteatosis in Non-Alcholic Fatty Liver Disease

OBJECTIVE: This study was designed to asses left ventricular functions and its relation with hepatosteatosis grade with conventional and tissue Doppler echocardiography in patients with the non-alcholic fatty liver disease. METHODS: 32 patients (15 males, 17 females; mean age 50±9 years and) with ultrasonographically diagnosed non-alcholic fatty liver disease and 22 healty subjects ( 11 female and 11 male; mean age: 50±10) without hepatosteatosis were enrolled in this study. Left ventricular systolic and diastolic functions, myocardial performance index and its relation with HS grade were assessed by conventional and tissue Doppler echocardiography. RESULTS: There were no statistically significant charasteristics difference, chambers diameters, standard Doppler parameters and conventional echocardiography parameters between the patients and control groups. Among tissue Doppler parameters the mitral annulus peak early diastolic velocity and ratio of early to late diastolic velocity were lower in patients group than in controls ( p < 0.001, p < 0.001 respectively). Isovolumetric relaxation time (IVRT) and myocardial performance index (MPI) were significantly higher ( p = 0.002, p < 0.001 respectively) in the patient group. There were no significant differences in mitral annuler late diastolic velocity, deceleration time of early diastolic filling, mitral annuler peak systolic velocity, isovolumetric contraction time and contraction time between the two groups. HS grade was positively correlated with the left ventricle MPI index ( r = 0.57 p = 0.001). SONUC: Bu sonuclar, alkolsuz yagli karaciger hastaligi olan hastalarda hepatosteatoz derecesi ile sol ventrikul diyastolik fonksiyon bozuklugunun iliskili oldugunu gostermektedir. CONCLUSION: These results show that left ventricular diastolic dysfunctions in patients with non-alcholic fatty liver disease and degree of hepatosteatosis is associated with left ventricular diastolic dysfunctions.

Effect of Antiepilepsy Drug Therapy on Ventricular Function in Children With Epilepsy: A Tissue Doppler Imaging Study

Impaired cardiac myocardial function may contribute to the risk for sudden unexpected death of a patient with epilepsy. This study aimed to investigate the effect of antiepilepsy drugs (AEDs) on cardiac function in pediatric epileptic patients using standard and tissue Doppler imaging (TDI) echocardiography. This hospital-based, prospective cross-sectional study investigated 52 epileptic children (mean age 9.3±3.1years) treated with AEDs (duration 2.4-10.0years) and 36 healthy children (mean age 9.5±4.0years). In the epilepsy group, standard echocardiography showed increased left ventricular (LV) end-diastolic and end-systolic diameters, an increased LV mass index, and preserved ejection fraction. The patients also exhibited increased mitral peak A-wave velocity and mitral E-wave deceleration time as well as a decreased mitral E/A ratio. The E/Em ratio was significantly higher in the epilepsy group (5.6±1.2) than in the control group (5.2±1.1) (p=0.016). In the epilepsy group, TDI showed an increased isovolumetric relaxation time and myocardial performance index (MPI). It also exhibited decreased early diastolic velocity (Em) and a decreased mitral annular displacement index in these patients. There were positive correlations between the LV lateral wall MPI (r=0.231), septal MPI (r=0.223), and LV mass index (p<0.05) but no correlation with the duration of AED treatment. The authors detected subclinical ventricular dysfunction associated with AEDs at a preclinical stage. They suggest that TDI can be useful for determining the short- and long-term cardiac effects of AEDs.

121: Left ventricular diastolic function evaluation by left atrial volume and myocardial performance index in patients with acute myocardial infarction

Both left atrial volume index (LAVI) and myocardial performance index (MPI) were proved to be reliable parameters of left ventricular (LV) diastolic function. We aimed to assess their usefulness in the setting of acute myocardial infarction (AMI) in comparison with conventional diastolic parameters A cohort of three hundred and sixty patients with AMI (72% with ST segment elevation) with a mean age of 61.6 ±12.4 years (79% males; 39% diabetics) was enrolled. Patients with atrial fibrillation or conduction abnormalities were excluded from the study. All patients had a conventional and Doppler echocardiography assessment 24 to 36 hours after admission coupled with a measurement of LAVI and MPI index by conventional Doppler method (MPI1), tissue Doppler method at the lateral side of the mitral annulus (MPI2) and at its medial side (MPI3). Correlation between parameters was evaluated by Pearson coefficient (r). The three MPI indexes were significantly correlated to these parameters of LV diastolic function: The early diastolic tissue velocities at the lateral side of the mitral annulus (Ea l) (r1=−0.31, r2=−0.36, r3=−0.46, p<0.001) and its medial side (Ea s) (r1=−0.37, r2=−0.35, r3=−0.34, p<0.001) and the combined parameter Early diastolic velocity by conventional Doppler (E)/ Ea s (r1=0.2, r2=0.2, p<0.01). LVAI was not correlated to MPI (r1=0.14, r2=0.11, r3=0.11, p>0.05) and it was only correlated with the early diastolic tissue velocity at the medial side of the mitral annulus (Ea s) (r=−0.18, p<0.05). While myocardial performance conventional and tissue indexes are strongly correlated with diastolic LV function in the acute phase of myocardial infarction, left atrial volume index seems be not sensitive to acute but only chronic alterations of this function.

The Assessment and Potential Implications of the Myocardial Performance Index Post Exercise in an at Risk Population.

BackgroundThe myocardial performance index (MPI) first described by Chuwa Tei in 1995 is a relatively new echocardiographic variable used for assessment of overall cardiac function. Previous studies have demonstrated the MPI to be a sum representation of both left ventricular systolic and diastolic function with prognostic value in patients with coronary artery disease as well as symptomatic heart failure.MethodsNinety patients with either established coronary artery disease (CAD) or CAD risk factors underwent routine treadmill exercise stress testing with two-dimensional Doppler echocardiography using the standard Bruce protocol. Both resting and stress MPI values were measured for all 90 of the patients.ResultsUsing a normal MPI cut off of ≤ 0.47, the prevalence of an abnormal resting MPI in our 90 subjects was 72/90 or 80% and the prevalence of an abnormal stress MPI in our 90 subjects was 48/90 or 53.33%. The average MPI observed in the resting portion of the stress test for the cohort was: 0.636 with a standard deviation of 0.182. The average MPI in the stress portion of the stress test for the cohort was 0.530 with a standard deviation of 0.250. The P value with the use of a one-tailed dependent T test was calculated to be < 0.05.ConclusionWe postulate that these findings reflect that the MPI (Tei) index assessed during exercise may be a sensitive indicator of occult coronary disease in an at risk group independent of wall motion assessment.

Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study

The present study aims to study the relationship between tissue Doppler echocardiography (TDE) indices of right ventricle and exercise capacity in patients after total correction for tetralogy of Fallot (ToF). This cross-sectional observational study included 20 patients, after undergoing total correction procedure for ToF diagnosed with mild/moderate pulmonary regurgitation and 30 age-matched healthy children. In the postoperative period, patients were invited to hospital for evaluation of the ventricular functions by 2D, M-mode, Doppler (DE) echocardiography and TDE and exercise testing to evaluate the effort capacity. Statistical analysis was performed using Mann-Whitney U and Chi-square tests, and Pearson correlation analysis. Compared with the controls; the mitral annular peak systolic flow velocity (Sm) value was significantly lower, while isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and myocardial performance index (MPI) values obtained at the tricuspid and mitral (MV) valves were significantly higher (p<0.05 for all) in patients after ToF repair. There was a negative correlation between the exercise period and the total correction age (r=-0.20, p=0.015) and the same negative correlation existed between the exercise period and METS (r=-0.25, p=0.010). MV IVCT with DE and TDE was found to be correlated with METS (r=-0.45, p=0.04). Left ventricular MPI was found to be correlated with maximum heart rate (r=-0.20, p=0.03). By DE, tricuspid valve deceleration time and Sm peak flow velocity with TDE were significantly correlated with METS (r=-0.30, p=0.04; r=-025, p=0.005, respectively). MPI calculated with TDE was correlated with maximum heart rate (r=-0.15, <0.01). Even if patients, undergone total correction surgery for ToF were asymptomatic or had minimal clinical symptoms, MPI index assessed by pulse wave TDE and exercise testing may allow early diagnosis of right ventricle dysfunction.

Effect of Blood Donation Mediated Volume Reduction on Right Ventricular Function Parameters in Healthy Subjects

We aimed to investigate the effect of controlled and limited volume change by the blood donation model to the right ventricular (RV) function via different echocardiographic parameters in healthy adults. Study population was composed of 71 healthy subjects who were volunteers for blood donation and evaluated before and after 450 mL blood donation. Pulsed-wave Doppler of the RV inflow and tissue Doppler of tricuspid lateral annulus, and tricuspid annular plane systolic excursion (TAPSE) were assessed. E velocity of inflow decreased significantly (67.6 ± 15.9 vs 60.9 ± 12.2, P = 0.006). S' and A' velocities did not change (15.3 ± 3.2 vs 15.2 ± 2.5 cm/s, P = NS; 14.1 ± 3.3 vs 13.4 ± 3.1 cm/s, P = NS, respectively) but E' showed significant decrease (13.7 ± 2.9 vs 12.2 ± 3.2 cm/s, P = 0.011). E'/A' ratio and E/E' ratio were found to be unchanged (1.0 ± 0.3 vs 1.0 ± 0.4, P = NS; 5.1 ± 2 vs 5.3 ± 2, P = NS, respectively). Myocardial performance index (MPI) was found to be increased but ejection time obtained from the tricuspid annulus did not change (0.50 ± 0.13 vs 0.54 ± 0.11, P = 0.040; 243 ± 37 vs 240 ± 27, P = NS, respectively). Isovolumetric relaxation and contraction times showed difference close to the significance limit (56 ± 19 vs 64 ± 23 ms, P = 0.055; 61 ± 16 vs 67 ± 16 ms, P = 0.062, respectively). TAPSE decreased significantly (2.62 ± 0.29 vs 2.41 ± 0.27 mm, P = 0.005). E' velocity and TAPSE were sensitive to a volume reduction as little as 450 mL in healthy subjects. MPI index of the tricuspid annulus is less sensitive than E' and TAPSE but need much care under changing volume state. However S' and A' velocity and E'/A' ratio were found to be resistant to the effects of volume depletion.

Improvements in cardiac form and function after transcatheter closure of secundum atrial septal defects

We set out to study the effect of transcatheter closure of atrial septal defect (ASD) on right ventricular (RV) and left ventricular (LV) function assessed by myocardial performance index (MPI), as well as left atrial (LA) volumes. The hemodynamic response to the closure of ASD is well-documented in surgically treated patients. However, few studies have documented echocardiographic evaluation of ventricular function in patients undergoing transcatheter closure of ASDs. Pre- and post-ASD device closure echocardiograms of 25 consecutive patients were retrospectively reviewed. Measurements of RV and LV MPI and LA volumes were made. Twenty-five patients with an average age of 45.5 +/- 16.3 years underwent transcatheter closure of ASD. There was statistically significant improvement in RV MPI (0.35 to 0.28, p = 0.004), LV MPI (0.37 to 0.31, p = 0.04), and LA volume index (25.7 to 21.8 ml/m(2), p < 0.001) after closure of ASD. Device closure of ASDs leads to improvement of both RV and LV function as well as reduction in LA volume. These hemodynamic improvements provide insights into the symptomatic benefits gained in closure of ASDs using the transcatheter approach.