Key result
Haemodialysis significantly increased both PDE- and TDE-Tei indices (P<0.001 and P=0.022), but TDE-Tei was less preload-dependent in patients with <3 kg body weight reduction.
Why the study?
Does haemodialysis-induced preload alteration affect the Tei index measured by pulsed and tissue Doppler echocardiography in uraemic patients?
Observational (n=38)
Does haemodialysis-induced preload alteration affect the Tei index measured by pulsed and tissue Doppler echocardiography in uraemic patients?
p-value: p=<0.001, 0.022
Both PDE- and TDE-Tei indices are preload-dependent, but the TDE-Tei index is less affected by small preload changes (<3 kg weight reduction) during haemodialysis, making it more accurate for assessing global left ventricular function in this setting.
Preload reduction by HD strengthens PDE-TDE Tei correlation; leaves open optimal method for serial assessment in uraemic patients.
OBJECTIVE: The aim of this study is to evaluate and compare the impact of preload alterations by haemodialysis (HD) on the Tei index obtained by pulsed Doppler echocardiography (PDE-Tei index) and tissue Doppler echocardiography (TDE-Tei index). METHODS AND RESULTS: Thirty-eight uraemic patients underwent echocardiography 1 hour before and 1 hour after HD was studied. Before HD, PDE- and TDE-Tei indices had a weak correlation (r = 0.439, P = 0.006). After HD, the correlation became stronger (r = 0.794, P < 0.001). After HD, body weight (P < 0.001), early transmitral filling wave peak velocity (E) (P < 0.00 1), early diastolic mitral annular velocity (Em) (P < 0.00 1), and E/Em (P = 0.00 1) decreased and PDE- (P < 0.00 1) and TDE-Tei indices (P = 0.022) increased significantly. In addition, after HD, body weight reduction had a significant correlation with E decrease and PDE- and TDE-Tei index increase (P < 0.00 1, P = 0.005, and P = 0.016, respectively). A subgroup comparison showed that in patients with body weight reduction < 3 kg, the PDE-Tei index (P = 0.003) increased significantly but TDE-Tei index (P = 0.209) did not change after HD. In patients with body weight reduction > or = 3 kg, both the PDE- and TDE-Tei indices (P = 0.003 and 0.042, respectively) increased significantly after HD. CONCLUSIONS: Both the PDE- and TDE-Tei indices are preload-dependent indicators. However, TDE-Tei index is less preload-dependent and is more accurate in assessing global left ventricular function in patients with body weight reduction < 3 kg after HD.
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Su et al. (2007) conducted an observational in Uraemia (n=38). Haemodialysis vs. Before haemodialysis was evaluated on PDE-Tei and TDE-Tei indices (p=<0.001, 0.022). Haemodialysis significantly increased both PDE- and TDE-Tei indices (P<0.001 and P=0.022), but TDE-Tei was less preload-dependent in patients with <3 kg body weight reduction.
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