Key result
An increased Tei index was significantly associated with the absence of adequate coronary reperfusion (TIMI 0-2) compared to those with good reperfusion (0.60 vs 0.46, p<0.0001).
Why the study?
Does an increased Tei index measured by Doppler echocardiography predict the absence of adequate coronary reperfusion in patients with first anteroseptal AMI?
Observational (n=85)
Single-blind
Yes
Does an increased Tei index measured by Doppler echocardiography predict the absence of adequate coronary reperfusion in patients with first anteroseptal AMI?
Absolute Event Rate: 0.6% vs 0.46%
p-value: p=<0.0001
An increased Tei index (>0.50) measured by Doppler echocardiography upon hospital arrival is a useful noninvasive marker to predict the absence of adequate coronary reperfusion in patients with first anteroseptal AMI.
Tei index may aid noninvasive identification of failed reperfusion in AMI; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: The estimation of coronary reperfusion in acute myocardial infarction (AMI) is important. The left ventricular (LV) Tei index is a noninvasive and sensitive parameter expressing overall LV function. We hypothesized that patients without good coronary reperfusion have worse LV function with a higher or worse Tei index compared to those with good reperfusion. METHODS AND RESULTS: In 85 patients with first anteroseptal AMI, without other cardiac lesions such as prior myocardial infarction, LV hypertrophy or valvular disease, the Tei index was measured using Doppler echocardiography immediately after patients' arrival to the hospital, and the Thrombolysis in Myocardial Infarction (TIMI) grade was evaluated through subsequent coronary angiography. The Tei index was significantly greater in patients who did not have TIMI score of 3 compared to those with a TIMI of 3 (0.60+/-0.13 vs 0.46+/-0.06, p<0.0001). A Tei index >0.50 as the criteria for the absence of TIMI 3 had the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 75, 86, 94, 54 and 78%, respectively. CONCLUSION: An increased Tei index suggests the absence of adequate coronary reperfusion in patients with first anterior AMI without other lesion.
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Kuwahara et al. (2006) conducted an observational in First anteroseptal acute myocardial infarction (n=85). Impaired coronary reperfusion (TIMI 0-2) vs. Good coronary reperfusion (TIMI 3) was evaluated on Left ventricular Tei index (p=<0.0001). An increased Tei index was significantly associated with the absence of adequate coronary reperfusion (TIMI 0-2) compared to those with good reperfusion (0.60 vs 0.46, p<0.0001).
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