A TEI index ≥0.65 accurately differentiated pseudonormal/restrictive from normal mitral flow with 82% sensitivity, 96% specificity, and an area under the curve of 0.95.
Cross-Sectional (n=33)
Single-blind
No
Does the TEI index accurately differentiate pseudonormal/restrictive from normal mitral flow in patients with mitral flow E/A >= 1?
The TEI index measured by Doppler echocardiography provides a highly accurate, noninvasive method to differentiate pseudonormal/restrictive from normal mitral flow.
Effect estimate: AUC 0.95 (95% CI 0.88-1.0)
p-value: p=<0.0001
Differentiation of normal from pseudonorma/restrictive mitral flow is not necessarily easy. Pseudonormal/restrictive flow is usually associated with left ventricular (LV) dysfunction, which can be detected using the TEI index, combining systolic and diastolic function. The purpose of this study was to test the feasibility of using the TEI index to differentiate pseudonormal/restrictive from normal mitral flow. In 33 patients with mitral flow E/A > or = 1 and LV mid-diastolic pressure measured by catheterization, the LV volumes, mitral E and A velocity, deceleration time of the E velocity, and the TEI index, defined as the sum of the isovolumic contraction and relaxation time divided by ejection time, were evaluated using Doppler echocardiography. Pseudonormal/restrictive mitral flow was defined as mitral flow E/A > or = 1 associated with LV mid-diastolic pressure > 12 mmHg. There were 22 and 11 patients with normal and pseudonorma/restrictive mitral flow, respectively. Among the indices of LV function, the TEI index achieved the best correlation with LV mid-diastolic pressures (r2 = 0.63, p or = 0.65 as the criteria for pseudonormal/restrictive mitral flow, this diagnosis had sensitivity, specificity, and accuracy of 82%, 96%, and 91%, respectively. TEI index allows noninvasive differentiation of pseudonormal /restrictive from normal mitral flow.
Zhang et al. (Tue,) conducted a cross-sectional in Pseudonormal/restrictive mitral flow (n=33). TEI index vs. Other echocardiographic indices of LV function was evaluated on Diagnosis of pseudonormal/restrictive mitral flow (defined as LV mid-diastolic pressure >12 mmHg) (AUC 0.95, 95% CI 0.88-1.0, p=<0.0001). A TEI index ≥0.65 accurately differentiated pseudonormal/restrictive from normal mitral flow with 82% sensitivity, 96% specificity, and an area under the curve of 0.95.