Measurement of the Myocardial Performance Index in Ambulatory Patients with Heart Failure: Correlation with Other Clinical and Echocardiographic Parameters and Independent Prognostic Value

BACKGROUND: Many echocardiographic parameters have been proposed for the assessment of the patients with heart failure (HF). Recently, the myocardial performance index (MPI) has been shown to be an accurate index of myocardial function. We assessed the correlation with other clinical and echocardiographic measurements and the prognostic value of MPI in patients with HF. METHODS AND RESULTS: The MPI was assessed in 112 consecutive patients with persistent symptoms of HF (II-III NYHA class), sinus rhythm, LV systolic dysfunction (defined by an ejection fraction <or= 45%). At multivariable analysis, only NYHA class and ejection fraction were independently related to MPI. The severity of mitral regurgitation and MPI were the only parameters independently related to the incidence of death or cardiovascular hospitalizations. A MPI > 0.55 (median value) and medium to severe mitral regurgitation were associated with a relative risk of cardiovascular events of 18.7 (95% confidence interval [CI], 16.6-20.7; P < 0.005) and of 3.03 (95% CI, 2-4.1; P = 0.035), respectively. CONCLUSIONS: In our patients with HF, MPI was the best predictor of cardiovascular events. Mitral regurgitation was the only other variable which had an additive prognostic value at multivariate analysis.