R-Wave Modified Tissue Doppler Imaging Myocardial Performance Index for the Assessment of Cardiac Function in Children with Congestive Heart Failure: A Feasibility Study

Figures

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  Figure 1. Doppler ultrasound mapping of the motion of the cardiac mitral valve annulus and the R-wave modified tissue Doppler imaging myocardial performance index (MPI TDI-R). The volume of the left ventricle (LV) free wall. The mitral valve flow spectrum includes the time interval of the endpoint of peak A to the onset of peak E, which is measured and defined as the time interval, which includes isovolumetric contraction time (ICT), ejection time (ET) and isovolumetric relaxation time (IRT). The myocardial performance index (MPI)=(ICT+IRT)/ET=(a–b)/b. The R-wave modified tissue Doppler imaging (TDI) myocardial performance index (MPI) or MPI TDI-R=(aR–b)/b. TDI – tissue Doppler imaging; MPI – myocardial performance index; LV – left ventricle; ICT – isovolumetric contraction time; ET – ejection time; MPI TDI – tissue Doppler imaging myocardial performance index; MPI TDI-R – R-wave modified tissue Doppler imaging myocardial performance index.

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  Figure 2. Comparison between the diameter as measured by the R-wave modified tissue Doppler imaging myocardial performance index (MPI TDI-R), with the classic or standard tissue Doppler imaging myocardial performance index (MPI TDI) diameter. TDI – tissue Doppler imaging; MPI – myocardial performance index; LV – left ventricle; ICT – isovolumetric contraction time; ET – ejection time; MPI TDI – tissue Doppler imaging myocardial performance index; MPI TDI-R – R-wave modified tissue Doppler imaging myocardial performance index.

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  Figure 3. Comparison between the diameter as measured by the R-wave modified tissue Doppler imaging myocardial performance index (MPI TDI-R) with the classic or standard modified tissue Doppler imaging myocardial performance index (MPI TDI). TDI – tissue Doppler imaging; MPI – myocardial performance index; LV – left ventricle; ICT – isovolumetric contraction time; ET – ejection time; MPI TDI – tissue Doppler imaging myocardial performance index; MPI TDI-R – R-wave modified tissue Doppler imaging myocardial performance index.

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  Figure 4. Scatter diagram to compare the findings of the R-wave modified tissue Doppler imaging myocardial performance index (MPI TDI-R) with the clinical Ross grades used to classify heart failure in children [6]. TDI – tissue Doppler imaging; MPI – myocardial performance index; LV – left ventricle; ICT – isovolumetric contraction time; ET – ejection time; MPI TDI – tissue Doppler imaging myocardial performance index; MPI TDI-R – R-wave modified tissue Doppler imaging myocardial performance index.

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  Figure 5. Comparison of receiver-operating characteristic (ROC) curve characteristics for the tissue Doppler imaging myocardial performance index (MPI TDI) with the R-wave modified tissue Doppler imaging myocardial performance index (MPI TDI-R). The area under the curve (AUC), for the receiver-operating characteristic (ROC) curves, are shown in parentheses. TDI – tissue Doppler imaging; MPI – myocardial performance index; LV – left ventricle; ICT – isovolumetric contraction time; ET – ejection time; ROC – receiver-operating characteristic; AUC – area under the curve; MPI TDI – tissue Doppler imaging myocardial performance index; MPI TDI-R – R-wave modified tissue Doppler imaging myocardial performance index.