Evaluation of Right Ventricular Function in Patients With Congestive Left Heart Failure by the Doppler Derived Total Cardiac Performance Index (TEI index)

Background. This study aimed to assess the serial changes of right ventricular (RV) function in patients with congestive heart failure (CHF) from the acute to the convalescent stage using the Doppler derived total cardiac performance index (TEI index).Methods. Sixteen patients (11 men; mean age, 67 years) with acute left heart failure and sinus rhythm were studied by two-dimensional and Doppler echocardiography during the acute and convalescent stages of CHF. The ratio of early to late diastolic filling velocity (E/A) of both ventricles and the volume and ejection fraction of the left ventricle (LV) were measured. The isovolumic contraction (RVICT), relaxation times (RVIRT), and the ejection time (RVET) were measured from the recordings of the RV inflow or outflow velocities and the electrocardiogram. The RV TEI index was calculated as (RVICT + RVIRT) / RVET.Results. During the acute stage, the RVICT and RVIRT were prolonged, the RVET was shortened, and subsequently the RV TEI index was increased. As the condition improved, the RVICT and RVIRT were shortened, the RVET was prolonged, and the RV TEI index was significantly decreased along with a decrease in the LV volume and an increase in the LV ejection fraction.Conclusions. The RV TEI index seems to be useful for evaluating global RV function in patients with congestive left heart failure.