Value of tissue Doppler-derived Tei index and two-dimensional speckle tracking imaging derived longitudinal strain on predicting outcome of patients with light-chain cardiac amyloidosis

Figures

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  Fig. 1. Example of a Tissue Doppler derived Tei index. Time intervals of left ventricle are measured with tissue Doppler imaging and the Tei index is calculated by the formula: (MCO-ET)/ET. MCO mitral valve closure-to-opening time, ET ejection time, IVCT isovolumetric contraction time, IVRT isovolumetric relaxation time, S′ peak systolic septal mitral annular velocity, E′ peak early-diastolic septal mitral annular velocity, A′ peak late-diastolic septal mitral annular velocity

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  Fig. 2. Kaplan–Meier estimation of Tei index, GLSsys, and E/GLSRdias for predicting all-cause mortality in patients with light-chain cardiac amyloidosis (AL-CA). Note that increased Tei index (a ≥0.9, P < 0.001), reduced GLSsys (b ≤13%, p = 0.019), or increased E/GLSRdias ratio (c ≥2.0, P < 0.001) was associated with significantly increased risk of all-cause death within 1 year in patients with AL-CA. GLS sys global longitudinal systolic strain, E/GLSR dias peak early diastolic mitral inflow velocity to global early diastolic strain rate ratio

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  Fig. 3. Comparison of prognostic performance of Tei index ≥0.9 and GLSsys ≤13% in patients with light-chain cardiac amyloidosis. Scatter plots depicting the correct and wrong attribution of having died after 1 year of follow-up using certain thresholds derived from study data. Excellent prognostic performance for predicting 1-year all-cause mortality is observed using Tei index ≥0.9 plus GLSsys ≤13% with a specificity of 100% and a sensitivity of 47%. GLS sys global longitudinal systolic strain, Sp specificity, Se sensitivity

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  Fig. 4. Comparison of prognostic performance of Tei index between light-chain cardiac amyloidosis patients with NYHA class I–II and III–IV. Note that in patients with NYHA class I–II, a significantly increased Tei index (≥0.9) was present in none (0/20) of survivors, but in 25% (2/8) of non-survivors (p = 0.074). Conversely, in patients with NYHA class III–IV, a normal Tei index (<0.5) was found in 18.2% (2/11) of survivors and in 26.3% (5/19) of non-survivors (p > 0.05). NYHA class New York Heart Association functional class