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Background: Sacubitril/Valsartan (ARNI) has now class 1 recommendation for treatment of heart failure with reduced ejection fraction (HFrEF). It has been shown to reduce cardiovascular morbidity & mortality in Heart failure with reduced ejection fraction (HFrEF) and significant improvement in all echocardiographic parameters besides TEI index. Tei index is a marker of inflammation, myocardial cell metabolism and its contractile function has not been evaluated as a distinctive entity so we took up this study to evaluate the effects of ARNI on the LV functions using two dimensional (2D)ECHO parameters in Indian population and to assess TEI index for myocardial function. Methods: 256 patients with class II, III or IV HF and EF

Yenidoğan kalbi, hem biyokimyasal hem de yapısal özellikler açısından yetişkin kalbinden farklıdır. İnsan neonatolojisindeki ekokardiyografik çalışmalar, prematüre bebeklerin sol ventrikülünün (LV) miyokardiyal fonksiyonunun zamanında doğan bebeklerden farklı olduğunu göstermektedir. Şimdiye kadar neonatal hayvanlarda miyokardiyal performans indeksini (MPI) içeren hiçbir çalışmaya rastlanılmamıştır. Bu çalışmanın amacı prematüre buzağılarda LV MPI'yi değerlendirmek ve sağlıklı yeni doğmuş buzağılarla karşılaştırmaktır. Gününde doğmuş 10 sağlıklı buzağı ve 20 prematüre buzağı çalışmaya dahil edildi. Ekokardiyografik değerlendirmeler doğumdan sonraki 1, 2 ve 3. günlerde yapıldı ve izovolümik kontraksiyon zamanı (IVCT), izovolümik relaksasyon süresi (IVRT), ejeksiyon zamanı (ET) ve MPI PW doku Doppler görüntüleme (PW-TDI) ile değerlendirildi. Çalışmanın sonuçları, prematüre buzağıların LV IVRT'sinin sağlıklı term buzağılara göre daha kısa olduğunu gösterdi. Sağlıklı gününde doğmuş buzağıların LVMPI değeri prematüre buzağılara göre daha yüksekti. Sonuç olarak, MPI ölçümü neonatal buzağılarda uygulanabilir bir yöntemdir. Prematüre buzağıların MPI'sindeki önemli düşüşler ve daha kısa IVRT, duktus arteriyozusun (DA) kapanmamasının ve azalmış afterload'un bir sonucu olarak ortaya çıkabilmektedir. Ekokardiyografi ve Doppler görüntüleme tekniği, neonatal buzağılarda kardiyovasküler sistemi incelemek ve izlemek için yararlı araçlar olduğu ortaya konulmuştur., The neonatal heart is different from the adult heart in regard to both biochemical and structural features. Echocardiographic studies in human neonatology show that the myocardial function of left ventricle (LV) of premature infants differs from term infants. No study involving myocardial performance index (MPI) in neonatal animals has been performed until now. The objective of the present study was to evaluate LV MPI in premature calves and compare it to healthy newborn term calves. Ten healthy term and 20 premature calves were used. Echocardiographic evaluations were performed at days 1, 2, and 3 after birth and isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), ejection time (ET), and MPI calculated with PW tissue Doppler imaging (PW-TDI). Results of the study showed that the IVRT of the LV of premature calves was shorter than seen in healthy term calves. The LVMPI of healthy term calves was also higher than in premature calves. In conclusion, MPI measurement is feasible in neonatal calves. Significant decrements in MPI and shorter IVRT of preterm calves could be the result of the non-closure of the ductus arteriosus (DA), and along with the decreased afterload. Echocardiography and Doppler imaging technique are useful tools for exploring and follow up the cardiovascular system in neonatal calves.

Background: Cardiomyopathy usually causes a cardiac dysfunction resistant to treatment due to anthracycline. This study aimed to evaluate the changes in Tei-Index (myocardial performance index) in patients with malignancies treated with anthracycline. Material and Methods: This case-control study was done on 15 children who were treated with low-dose anthracycline (1-199mg/kg) called group A and 15 children who were treated with high dose (>200mg/kg) anthracycline called group B after acquiring consent from their parents. Children with no abnormality in Echo-Doppler results were included in this study. The patients’ age range between 1- 17 years with a mean age of 6.57 years. Another group of healthy children were assigned to group C as a control group who had not received chemotherapy. The first echo was performed right before the treatment and the second one, two weeks after completing chemotherapy. Data were analyzed by the SPSS statistical software. Results: Changes in mean Tei-index in group A were 0.36 ± 0.04 before treatment and 0.43 ± 0.11 after treatment. Changes in mean Tei-index in group B were 0.37 ± 0.04 before treatment and 0.45 ± 0.06 after treatment. There was no significant difference between the two groups using the independent T-test. (p-value= 0.57). No significant correlation between the changes in mean ejection fraction (EF) and treatment was found in the three groups (p-value=0.45). Conclusion: This study showed a change in the Tei-index (MPI) in patients receiving anthracycline; regardless of the dosage, they got in their regimen. Given the use of anthracycline, any abnormal cardiac finding can alert the physicians to the possibility of cardiomyopathy, hence scheduling routine follow-ups are necessary.

Background Anthracycline agents are known to be effective treatments for solid tumors and hematological malignancies. Although these agents improve survival, their use is associated with cardiotoxic effects, which most commonly manifests as left ventricular systolic dysfunction (LVSD). As such guidelines recommend the periodic assessment of left ventricular ejection fraction (LVEF). However, as diastolic dysfunction likely proceeds systolic impairment in this setting, the role of Tei index may offer additional benefit in detecting subclinical LVSD. Methods We conducted a systematic review to investigate the evidence for the use of Tei index in assessing for subclinical cardiotoxicity in patients receiving anticancer agents. A search of Medline and EMBASE was performed and relevant studies were reviewed and narratively synthesized. Results A total of 13 studies were included with a total of 800 patients (mean age range 46-62 years, percentage of male participants ranged from 0%-86.9%). An increase in Tei index was observed in 11 studies, which suggesting a decline in cardiac function following chemotherapy. Out of these, 6 studies indicated that the Tei index is a useful parameter in predicting cardiotoxic LVSD. Furthermore, 5 studies indicated Tei index to be superior to LVEF in detecting subclinical cardiotoxicity. Conclusions While there are some studies that suggest that Tei index may be a useful indicator in assessing for subclinical anthracycline related cardiotoxicity, the findings are inconsistent so more studies are needed before the evaluation of Tei index should be performed routinely in patients receiving chemotherapy.

Introduction: It was reported left ventricular global longitudinal strain (LVGLS) was useful to diagnose subclinical cardiotoxicity (SC) after chemotherapy. Doppler Tei index has been known as a noninvasive and useful indicator of systolic and diastolic myocardial performance. Until now, it has not been reported about the utility of Tei index in SC after anthracycline-based chemotherapy. Methods: We retrospectively enrolled patients with malignant lymphoma or acute myeloid leukemia receiving anthracycline-based chemotherapy from 2010 to 2019. Thirty patients were performed echocardiographic examination before and after chemotherapy. We measured LV parameters (LVGLS, LV end-diastolic diameter, LV end-systolic diameter, LV ejection fraction, LV-Tei index), and RV parameters (RV fractional area change, RV-Tei index). Patients were divided into SC and non-SC groups according to a relative percentage reduction in LVGLS of greater than 15% to baselines. Then, we compared LV and RV parameters between groups, and explored which parameters were related to SC. Results: Five patients (16%) were divided into SC group with decreased %ΔGLS (22.5±6.7%). LV end-diastolic diameter, LV end-systolic diameter, and RV fractional area change were slightly higher in non-SC although still no significance. ΔLV-Tei index and ΔRV-Tei index were significantly greater In SC group compared to non-SC group (0.22±0.10 versus 0.15±0.03, p=0.032. 0.18±0.08 versus 0.14±0.02, p=0.014, respectively). ΔLV-Tei index and ΔRV-Tei index significantly correlated with ΔGLS (r=0.46, p=0.009. r=0.39, p=0.03). Receiver-operating characteristic curve analysis identified the optimal ΔLV-Tei index and ΔRV-Tei cutoff for predicting SC as 0.09 and 0.05 (area under the curve of 0.81, p=0.029. 0.86, p=0.028). Conclusions: LV and RV-Tei index was affected by chemotherapy. Our study suggests that Tei index can be a useful indicator for SC after anthracycline-based chemotherapy.

Background:Echocardiographic evaluation of left ventricular ejection fraction (LVEF) is used in the risk stratification of patients with an acute myocardial infarction (AMI). However, the prognostic value of the Tei index, an alternative measure of global cardiac function, in AMI patients is not well established. Methods:We conducted a systematic review, using MEDLINE and EMBASE, to evaluate the prognostic value of the Tei index in predicting adverse outcomes in patients presenting with AMI. The data was collected and narratively synthesised. Results:A total of 16 studies were including in this review with 2886 participants (mean age was 60 years from 14 studies, the proportion of male patients 69.8% from 14 studies). Patient follow-up duration ranged from during the AMI hospitalisation stay to 57.8 months. Tei index showed a significant association with heart failure episodes, reinfarction, death and left ventricular thrombus formation in 14 out of the 16 studies. However, in one of these studies, Tei index was only significantly predictive of cardiac events in patients where LVEF was Conclusion:Tei index may be an important prognostic marker in AMI patients, however, more studies are needed to better understand when it should be used routinely within clinical practice

Background and Objective: It is important to make risk stratification for patients with non ST segment elevation MI to reduce mortality, reinfarctions and to improve prognosis. Through the echocardiographic parameters; ejection fraction does not reflect diastolic functions. Tei index is a new parameter representing both left ventricular systolic and diastolic functions at the same time. The aim of this study is to determine the relationship between Tei index and prognosis in patients with non ST segment elevation MI. Method: Fifty patients (mean age: 60.1±11) with non ST segment elevation MI were included to our study. All the patients were given standard care and managed according to well accepted guidelines. Clinical and laboratry data were collected during hospitalization. Echocardiographic examinations were done on the hospitalization day and 3 months after discharge. Tei index and other echocardiographic examinations were evaluated. Results: Mean value of the index through the patient group was 0.39±0.03, whereas it was 0.59±0.09 through control group (p:0.001). Through the follow up 14 patients (28%) had major cardiac adverse events (MACE). Tei index of deaths were significantly higher than alives (0.73±0.005 vs 0.58±0,09, p:0.002). Compared to uncomplicated patients, the mean Tei index was significantly higher in patients with complications (0.71±0.0 vs0.55±0.07, p:0.001). Death was observed in 4 patients (14.2%) in Tei index 0.60 group whereas no death was seen in Tei index

目的：探讨双脉冲多普勒技术测量Tei指数在成人健康体检中评估左室舒张功能的应用价值。方法：选取体检中心健康成人113例，根据脉冲多普勒二尖瓣下血流E/A值及组织多普勒二尖瓣环运动速度e’/a’比值分为组1 (41例完全正常)、组2 (40例E/A、e’/a’ 1而e’/a’ 1, e'/a' < 1). Three groups were measured by double pulse Doppler synchronous of left ventricular function, Tei index and E peak early diastolic mitral flow velocity of mitral annulus E ratio (E/e) and other parameters, and SPSS 19 statistical software was used for data analysis. Results: The Tei index in group 3 and group 2 were significantly higher than that in group 1, and there were differences between the three groups (P < 0.05). The group 2 was higher than group 1. Tei index has correlation with isovolumic IVRT, early diastolic mitral flow E, mitral annulus tissue Doppler e' (septal and lateral wall side) and E/A (P < 0.05). Diastolic dysfunction has a strong correlation with hypertension and family history of diabetes, smoking (1 packs/day) and alcohol, staying up late and sleep poorly, work pressure and other mental factors, obesity, lacking of exercise. Conclusion: Double pulse Doppler can measure Tei index synchronously, and improve the accuracy of diagnosis of left ventricular diastolic dysfunction.

Background: Acute myocardial infarction is one of the most common causes of mortality in developed countries, and high-sensitive troponin test usually becomes positive within 3 h from the onset of symptoms. Myocardial perfusion index (Tei index) is a parameter measured during the echocardiographic examination. Objectives: The aim of this study is to investigate the diagnostic value of the Tei index for early diagnosis of acute myocardial infarction in the emergency department and to evaluate the correlation between the Tei index and Hs-Troponin value. Materials and Methods: A total of 129 cases were evaluated, and patients were divided into two groups according to their final diagnosis as “acute myocardial infarction (non-ST segment elevation myocardial infarction)” and “non-acute myocardial infarction” groups. Baseline and third-hour Hs-Troponin levels and Tei index values were determined, and their correlation was analyzed. Results: A total of 84 cases were diagnosed with acute myocardial infarction (non-ST segment elevation myocardial infarction), 84.5% had positive Tei index results at the time of admission while the remaining 45 patients were diagnosed as non-acute myocardial infarction and only 48.9% of them had positive Tei index. The diagnostic value of the Tei index and Hs-troponin were calculated as 79.8% and 60%; 67.9% and 60%, respectively. Also, we found that a 0.02 or more increase in the Tei index value has a 97.6 sensitivity and 97.5 specificity for the diagnosis of non-ST segment elevation myocardial infarction. A weak correlation was found between the Tei index and Hs-Troponin values in the acute myocardial infarction group (r = 0.425) and a negative correlation in non-acute myocardial infarction patients at presentation. Conclusion: It is suggested that the use of Tei index might be used as a supportive measure for the early diagnosis of acute myocardial infarction, and the deterioration of Tei index seems to be more significant than Hs-Troponin especially in ruling out acute myocardial infarction.

Objective The aim of this study was to determine the usefulness of the Tei Index, an echocardiographic parameter, in the early determination of pulmonary artery pressure (PAP) in congenital heart disease (CHD) with a left-to-right shunt. Methods Right and left ventricular functions were evaluated using Tei Index values determined with tissue Doppler echocardiography. Cardiac catheterization was performed in all cases. The presence of pulmonary arterial hypertension (PAH) was defined as a mean PAP of ≥25 mm Hg and a pulmonary vascular resistance index of >3 WU/m2. Patients with a pulmonary/systemic blood flow ratio of ≥2 were considered candidates for surgery. Results The Tei Index values measured from the left ventricular posterior wall and the right ventricular anterior wall were found to be significantly higher in the patients with PAH (0.68±0.18, 0.67±0.16, respectively) compared with the patients without PAH (0.56±0.16, p=0.027; 0.51±0.12 p=0.001). A significant correlation was detected between the Tei Index value measured from the left ventricular posterior wall and the mean PAP (correlation coefficient: 0.491). Conclusion The right ventricular Tei Index values in children with CHD and a left-to-right shunt can be used as a parameter to follow up on the potential development of PAH, to make a diagnosis in the early period, and to make a timely decision about surgery.

Tei proposed an index of myocardial performance (IMP), which was devised to investigate combined measurement of systolic and diastolic function. The present study was undertaken to study importance of myocardial tei index in Dilated cardiomyopathy (DCM) and Mitral valve disease (MVD) affected dogs. A total of 63 dogs were examined for calculation of TEI index. Out of 63 dogs, 37 and 26 dogs suffering from DCM and MVD were taken as separate groups. LV Tei index was increased in both DCM and MVD affected dogs. The mean and standard error of the Tei index in DCM and MVD were 0.51±0.11 and 0.63±0.11, respectively and no significant difference was observed between these groups. Tei index appeared to correlate with severity of disease and can be used for early diagnosis of DCM.

Summary. Objective — a retrospective analysis of the causes of TEI complications and the results of their treatment. Materials and methods. The long-term results of performed TEI in 2909 patients were analyzed. The most common indication for TEI was choledocholithiasis, which was found in 1873 (65.4 %) patients and stenosis of papilla was detected in 454 (15.6 %) patients. Complications arose in 112 (3.85 %) patients. 4 (0.14 %) patients died. Results. Bleeding occurred in 28 (0.96 %) patients. In 12 of 26 patients, endoscopic hemostatic manipulations were additionally performed. Two patients with profuse bleeding from a papillotomy wound were urgently operated on, one patient died. Acute pancreatitis occurred in 68 (2.33 %) patients, of which 56 (1.92 %) had an edematous form, and 12 (0.41 %) patients had a destructive form. 11 patients were operated on from 2 to 15 days from the onset of the disease. Two patients with pancreatic necrosis died of intoxication, the source of which was progressive retroperitoneal necrosis. In 5 (0.17 %) patients, intervention on the papilla was complicated by perforation of the wall of the duodenum. 4 out of 5 patients were urgently operated on (B-2 antrumectomy, external drainage of the common bile duct and retro duodenal space). All 4 patients recovered. In 1 patient, complication was diagnosed on the 5th day after the intervention, which led to delayed surgery and the death of the patient. In 11 patients (0.38 %), a Dormia basket with a stone in the distal part of the common bile duct wedged when trying to extract it. Only one of 11 patients was operated on as planned; in the remaining 10, the problem was resolved with repeated TEI. Conclusions. Punctual technical implementation of all stages of manipulation, selective cannulation of the bile ducts, careful x-ray control of the position and advancement of the instrument in the ducts helps to reduce the number of complications after TEI.

Objective: Some patients who had chronic coronary syndrome (CCS) and were recognized as low risk, however, developed cardiovascular events, whereas others who were categorized as high risk did not develop any cardiovascular events. Invasive coronary angiography is the gold standard tool for the assessment of coronary artery disease (CAD) severity. The SYNTAX score (SS) was recently recognized as an invasive angiographic-guided scoring system used in risk stratification of patients who have more than one-vessel CAD and undergoing revascularization with percutaneous cardiovascular intervention. It has a good predictive value of adverse cardiovascular events. Exploration for unique noninvasive modalities that may help in a better way for risk stratification of CCS patients by predicting the severity of CAD (as reflected by SS) would be of a paramount value. Tei index is a promising modality for that objective, which is a Doppler-derived time interval index that combines both systolic and diastolic cardiac performance. Methods: We examined the relationship between the severity of CAD as assessed by the SS and Tei index in 100 patients with CCS and normal left ventricular systolic function. Results: All the studied 100 patients had a normal ejection fraction with mean = 58.92 ± 7.88; the mean value of Tei index was 0.84 ± 0.26. There was a statistically significant positive association between Tei index and SS (P = 0.0001); moreover, there was a correlation between left anterior descending (LAD) affection and Tei index (P = 0.0001).The cutoff point of Tei index to detect SS above 22 was >0.93 (with specificity of 86.5% and sensitivity of 42.4%). Conclusion: Tei index significantly correlates with SS and LAD affection. Moreover, it is a cheap, radiation-free, noninvasive technique and may be used as a further risk stratification modality beyond others.

SummaryBackgroundA Tei index is known to reflect overall cardiac performance including systolic and diastolic function in a variety of heart disease. We investigated the relationship between preoperative Tei index and postoperative left ventricular (LV) mass regression and survival after aortic valve replacement (AVR) for aortic valve stenosis (AS).MethodsOne hundred fifty-four patients with AS were classified into a group with abnormal (Abn) LV function (n=47, 0.45≤Tei index) and a group with normal (Nor) LV function (n=107, Tei index

Tei index, defined as the sum of isovolumic contraction and relaxation times divided by ejection time, has been proposed to express global left ventricular function. For patients with acute myocardial infarction (AMI), left ventricular function can potentially be a major determinant of hemodynamics with limited time for compensation, such as increased brain natriuretic peptide to attenuate congestion, and usually without any intervention to modify cardiac loading on arrival at the hospital during the acute phase. We, therefore, hypothesized that left ventricular function, expressed by the Tei index, allows noninvasive estimation of impaired hemodynamics for patients with AMI.We studied 86 consecutive patients with first AMI (34 inferoposterior and 52 anteroseptal). Tei index was obtained as: (a - b)/b, where a is the interval between the cessation and onset of mitral flow and b is the ejection time by aortic flow by pulsed Doppler echocardiography. By using pulmonary capillary wedge pressure (PCWP)or = 18 mm Hg or18 mm Hg and cardiac index (CI)or = 2.2 L/min/m(2) or2.2 L/min/m(2) by consecutive catheterization, patients were classified into 4 subsets: subset I with normal hemodynamics; subset II with elevated PCWP; subset III with reduced CI; and subset IV with both elevated PCWP and reduced CI.For patients with inferoposterior AMI, there was no significant correlation between the Tei index and PCWP or CI. For patients with anteroseptal AMI, however, the Tei index showed significant correlation both with PCWP (r = 0.59, P.0001) and CI (r = -0.42, P.01). Diagnosis of impaired hemodynamics (subset II-IV) by a Tei indexor = 0.60 showed a sensitivity, specificity, and accuracy of 86%, 82%, and 83%, respectively.Although the Tei index has limitations to evaluate hemodynamics in patients with inferoposterior AMI, the index allows approximate but quick and practical noninvasive estimation of impaired hemodynamics in patients with anteroseptal AMI.

Cardiac amyloidosis is an infiltrative disease causing predominant diastolic dysfunction and systolic dysfunction at its advanced stage. Right ventricular (RV) dysfunction is an independent predictor of poor prognosis in congestive heart failure and cardiomyopathies. However, the assessment of RV function is still technically difficult because of the complicated geometry of the RV. The recently proposed Tei index, obtained from the cardiac time interval analysis, allows noninvasive and quantitative estimation of global ventricular function without geometric evaluation. Therefore, this study was designed to assess RV function for patients with cardiac amyloidosis.Study patients consisted of 30 consecutive patients with biopsy specimen-proven cardiac amyloidosis and 50 control subjects. Patients were classified as having early or advanced stage of cardiac amyloidosis on the basis of mean left ventricular wall thickness15 mm or/= 15 mm. Tei index, defined as the sum of isovolumetric contraction and relaxation time divided by ejection time, was obtained from tricuspid and pulmonary Doppler flow velocity.RV Tei index was significantly increased for patients with cardiac amyloidosis (0.54 +/- 0.16 vs 0.28 +/- 0.05, amyloidosis vs control, P.001). The incidences of abnormal RV isovolumetric contraction time, ejection time, isovolumetric relaxation time, and Tei index in all patients with cardiac amyloidosis were 63%, 43%, 73%, and 83%, respectively. The same incidences were 50%, 13%, 63%, and 75% in the early stage and 68%, 54%, 77%, and 86% in the advanced stage, respectively.Patients with cardiac amyloidosis frequently have RV dysfunction even in its early stage. Tei index allows simple, noninvasive, and nongeometric estimation of RV dysfunction in patients with cardiac amyloidosis.

Background: Tei index expresses the overall systolic and diastolic myocardial function in a single number. The use of tissue Doppler instead of conventional pulsed wave Doppler enables us to measure Tei index in a single scan. It also has many advantages for the assessment of myocardial function with coronary revascularization in IHD patients. Methods: We included 47 chronic ischemic heart disease patients with LV dysfunction (EF

Background: Cardiac dysfunction is the major cause of morbidity and mortality in diabetes. Myocardial Performance Index (MPI/Tei Index) includes both systolic and diastolic time intervals to assess the global cardiac dysfunction. Our aim was to assess the MPI in patients with type 2 diabetes. Material and methods: This hospital-based analytic observational study was performed in the tertiary care center. The conventional Doppler parameters, tissue Doppler-derived E/E′ and MPI, were measured in all patients. Results: 100 patients with type 2 diabetes were included in the study. 65 patients showed diastolic dysfunction, 33 with Grade I diastolic dysfunction, 23 with Grade II diastolic dysfunction, and 14 patients with Grade III diastolic dysfunction. The conventional Doppler showed abnormality in 44% of patients (33 patients with Grade I and 14 patient with Grade III). 23 patients were in Grade II diastolic dysfunction (12 patients showed reversal E/A on valsalva maneuver and 11 patients showed abnormality in tissue Doppler-derived E/E′, E/E′ > 15). MPI with cut-off 0.36 was found to have 94% sensitivity, 100 specificity, and 94% PPV for the detection of cardiac dysfunction. MPI negatively correlated with systolic dysfunction (rho = 0.455, p

Differentiation of pseudonormal/restrictive from normal mitral flow is still clinically problematic. Pseudonormal/restrictive flow is usually associated with left ventricular dysfunction, which can be detected by Doppler Tei index, combining systolic and diastolic function. Therefore, the purpose of this study was to test the feasibility of the Tei index to differentiate pseudonormal/restrictive from normal mitral flow.In 26 patients with anteroseptal acute myocardial infarction and early diastolic mitral flow velocity (E) to late diastolic mitral flow velocity (A) ratio (E/A)or = 1, left ventricular volumes; E and A; deceleration time of E; and the Tei index, defined as the sum of the isovolumic contraction and relaxation time divided by ejection time, were evaluated by Doppler echocardiography, and pulmonary capillary wedge pressure was measured by catheterization. Pseudonormal/restrictive mitral flow was defined as E/Aor = 1 associated with pulmonary capillary wedge pressure12 mm Hg.There were 19 and 7 patients with pseudonormal/restrictive and normal mitral flow, respectively. Among the indices of left ventricular function, the Tei index achieved the best correlation with pulmonary capillary wedge pressure (r(2) = 0.66, P.0001). By setting the Tei indexor = 0.55 as the criteria for pseudonormal/restrictive mitral flow, this diagnosis had the sensitivity, specificity, and accuracy of 84%, 100%, and 88%, respectively.The Tei index allows noninvasive differentiation of pseudonormal/restrictive from normal mitral flow.

Background. Discrepancies between LV function and its filling pressure are typically characterized with severe dysfunction and normal filling pressure, suggesting reduced preload. Reduced preload can cause lower early to late diastolic mitral flow velocity ratio (E/A) on the Doppler echocardiogram. Therefore, we hypothesized that the relation between LV function and filling pressure is poorer in patients with mitral flow E/A < 1.0, however, the same relation is better in those with E/A ≥1.0.Objectives. The present study sought to investigate and compare the relation between LV filling pressure and indices of LV function, including the recently proposed Doppler Tei index, between patients with mitral flow E/A < 1.0 and those with the E/A ≥ 1.0.Methods. LV end-diastolic and mid-diastolic (before atrial contraction: pre-A) pressures were directly measured by catheterization in 74 consecutive patients with normal sinus rhythm. Tei index was measured from pulsed Doppler LV inflow and outflow velocity recordings, as the sum of isovolumetric contraction and relaxation time divided by LV ejection time. Indices of cardiac function including LV end-diastolic and end-systolic volumes, LV ejection fraction, left atrial dimension, mitral flow E/A, deceleration time of E velocity, and its slope were also measured by Doppler echocardiography.Results. In all subjects, there were no significant or relatively weak correlations between the LV filling pressures and indices of LV function (r2 = 0.05 ∼ 0.27, N.S. ∼ p < 0.0001). In patients with E/A < 1.0, the correlations were not significant for all indices of LV function. However, multiple indices of LV function, especially the Tei index, showed significant and better correlations with both LV end-diastolic and pre-A pressures (r2 = 0.66 and 0.63, p < 0.0001, respectively).Conclusions. Correlations between LV filling pressure and indices of LV function are worse and not significant in patients with mitral flow E/A < 1.0, however, the correlations are better and significant in patients with the E/A ≥ 1.0. Indices of LV function, especially Tei index, allows noninvasive estimation of LV diastolic filling pressure in patients with mitral E/A ≥ 1.0.

Assessment of left ventricular function in patients with chronic heart failure is important for determining prognosis and treatment plans. The prognostic values of the myocardium and global ventricular functions remain unclear. This cross-sectional study included 30 subjects obtained through purposive sampling. Global longitudinal strains (GLS) is used to assess the left ventricular systolic function and Tei index (TI) is used to assess both global systolic and diastolic ventricular function. SHFM scoring was calculated based on existing patient data. The mean GLS-left ventricle value was -8.08 ± 3.98, whereas TI value was 0.65 ± 0.14. GLS-left ventricle had significant negative correlation with estimated one and five years mortality based on SHFM score (r = - 0.676 and p = 0.0001) whereas TI had a significant positive correlation (r = 0.745 and p = 0.0001; r = 0.738 and p = 0.0001). GLS-left ventricle had a significant negative correlation with an estimated one and five years mortality based on SHFM score, whereas TI had a significant positive correlation. Hence it is suggested that GLS-left ventricle and TI can be a prognostic factor.

Twin Reverse Arterial Perfusion (TRAP) Sequence is a rare complication of monochorionic pregnancies. Without intervention, the viable pump twin in a case of TRAP Sequence may develop high output cardiac failure leading to an intrauterine fetal demise. We present 3 cases of TRAP Sequence pregnancy diagnosed during the second or third trimesters of pregnancy. There are minimal sonographic tools for the guidance of a fetal therapeutic interventional procedure during the second trimester or timing of delivery during the third trimester to reduce morbidity and mortality of a viable fetus. Tei index may be a useful sonographic tool in the management of TRAP Sequence during the second or third trimester of pregnancy.

Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory distress (group I), 15 with perinatal asphyxia (group II), and 10 apparently healthy neonates as a control (group III). All have: Detailed history-thorough clinical examination-Plain X-ray-ECG-Two dimensional, M-mode and Doppler echocardiographic examination with the measurement of both myocardial performance index (MPI) of the right and left ventricle-Serum cardiac troponin I. Results: There was statistically significant increase in serum cardiac troponin I in groups I and II than group III. Left and right ventricular myocardial performance index (MPI) were increased in group I and II than the control group. No correlation between Tei index and each of postnatal age, apgar score at 5-min, heart rate, serum cardiac troponin I, ejection fraction and fractional shortening, but there was direct relationship between MPI and LVEDD and inverse relationship between MPI and each of EF% and FS%. But there was significant correlation between L.V. MPI and gestational age. Conclusion: Tei index was higher in neonates with respiratory distress and neonates with perinatal asphyxia than in normal neonates despite normal or even increased ejection fraction which indicates that these patients may have subclinical ventricular dysfunction which should be followed up carefully.

Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Methods: Forty patients with respiratory failure due to acute exacerbation of COPD were enrolled to this study. All patients underwent a comprehensive echocardiographic examination including tissue doppler imaging within first 12 hours of admission. NT-pro BNP serum levels were measured on admission. Patients were followed up for outcome of weaning failure. Results: Right ventricular Tei index was higher in patients with failed weaning in comparison to successfully weaned patients (mean 0.66 versus 0.36, P < 0.001), also left ventricular Tei index was higher in patients who failed to be weaned (mean 0.45 versus 0.36, P = 0.007). There was no difference in serum NT-Pro BNP between successfully weaned patients and patients with weaning failure. Right ventricular Tei index showed higher accuracy in predicting weaning failure than the left ventricular Tei index (AUC 0.932 versus 0.754), while serum NT-Pro BNP showed no discrimination in predicting weaning failure (AUC 0.556). Conclusion: Tei index was superior to NT-ProBNP in prediction of weaning failure in COPD patients.

Aim. To evaluate the informational and diagnostic significance of the myocardial Tei index.Patients and methods. The study assessed data of echocardiographic studies of 9,256 patients aged 1 month to 60 years, 1,350 healthy individuals, and 7,906 patients with various cardiovascular diseases with abnormal volume-capacitive characteristics of the heart (congenital heart defects, different types of cardiopathy, and hypertensive disease).Results. The cutting points of the normal values of the indicator were established. Data showed that the Tei index did not reflect changes in the pumping function of the left ventricle and did not depend on the contractility of the left ventricle (LV), but it had direct significant correlation with the left ventricular filling pressure, both in normal and pathological conditions. Correlation was more significant in adult patients.Conclusion. Normal values of the Tei index less than 0.5 were observed in more than 95% of practically healthy individuals of any age. The maximum sensitivity and specificity of the myocardial performance index was found in patients with restrictive and dilated cardiopathy and common atrioventricular connection.

Aim. To evaluate the informational and diagnostic significance of the myocardial Tei index.Patients and methods. The study assessed data of echocardiographic studies of 9,256 patients aged 1 month to 60 years, 1,350 healthy individuals, and 7,906 patients with various cardiovascular diseases with abnormal volume-capacitive characteristics of the heart (congenital heart defects, different types of cardiopathy, and hypertensive disease).Results. The cutting points of the normal values of the indicator were established. Data showed that the Tei index did not reflect changes in the pumping function of the left ventricle and did not depend on the contractility of the left ventricle (LV), but it had direct significant correlation with the left ventricular filling pressure, both in normal and pathological conditions. Correlation was more significant in adult patients.Conclusion. Normal values of the Tei index less than 0.5 were observed in more than 95% of practically healthy individuals of any age. The maximum sensitivity and specificity of the myocardial performance index was found in patients with restrictive and dilated cardiopathy and common atrioventricular connection.

Objectives: The aim of the study was to evaluate the role of myocardial performance index (Tei index) in the assessment of ischemic cardiac damage in neonates with respiratory distress and perinatal asphyxia. Patients and Methods: This is a descriptive cross-sectional study conducted on 40 neonates in the NICU of Bab-El Shaarya University Hospital in 6 months period from January 2018 to June 2018. They were 22 males and 18 females with post-natal age 1-7 days, 15 with perinatal asphyxia (group1), 15 with respiratory distress(group2) and 10 normal as a control group(group3). Detailed history, thorough clinical examination, chest x-ray, ECG, Two-Dimensional echo, M- mode and Doppler (pulsed &tissue) echocardiographic examinations with the measurement of myocardial performance index ((ICT "isometric contraction time"-IRT "isometric relaxation time”)/ET "ejection time”) of the left and right ventricles. Results: There was statistically significant increase in the-myocardial performance index in group 1&2than group3. There was inverse relationship between Tei index and each of ejection fraction and fraction shortening and there was statistically significant correlation between LV Tei index and gestational age. Conclusion: Tei index was higher in neonates with respiratory distress and neonates with perinatal asphyxia than in normal neonates despite normal or even increased ejection fraction which indicates that these patients may have subclinical ventricular dysfunction which should be followed up carefully. Recommendation: Tei index is recommended to assess ventricular function in neonates with respiratory distress or perinatal asphyxia as our study revealed that it is not affected by age or heart rate and it doesn't depend on ventricular geometry.

Teicoplanin has a potential antiviral activity expressed against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and was suggested as a complementary option to treat coronavirus disease 2019 (COVID‐19) patients. In this multicentric, retrospective, observational research the aim was to evaluate the impact of teicoplanin on the course of COVID‐19 in critically ill patients. Fifty‐five patients with severe COVID‐19, hospitalized in the intensive care units (ICUs) and treated with best available therapy were retrospectively analysed. Among them 34 patients were also treated with teicoplanin (Tei‐COVID group), while 21 without teicoplanin (control group). Crude in‐hospital Day‐30 mortality was lower in Tei‐COVID group (35.2%) than in control group (42.8%), however not reaching statistical significance (p = .654). No statistically significant differences in length of stay in the ICU were observed between Tei‐COVID group and control group (p = .248). On Day 14 from the ICU hospitalization, viral clearance was achieved in 64.7% patients of Tei‐COVID group and 57.1% of control group, without statistical difference. Serum C‐reactive protein level was significantly reduced in Tei‐COVID group compared to control group, but not other biochemical parameters. Finally, Gram‐positive were the causative pathogens for 25% of BSIs in Tei‐COVID group and for 70.6% in controls. No side effects related to teicoplanin use were observed. Despite several limitations require further research, in this study the use of teicoplanin is not associated with a significant improvement in outcomes analysed. The antiviral activity of teicoplanin against SARS‐CoV‐2, previously documented, is probably more effective at early clinical stages., Highlights ‐Evidence from the scientific literature highlighted that a number of glycopeptide antibiotics have a potential antiviral activity expressed against Coronaviruses. Based on the aforementioned, teicoplanin was suggested as an alternative complementary option to treat also SARS‐CoV‐2 infected patients‐Teicoplanin also remain a possible choice for treatment of Staphylococcus aureussuperinfection, a major complication of respiratory viral infections and in COVID related pneumonia.‐This is the first multicentric, retrospective, observational analysis of a real‐life cohort of critically ill patients with COVID‐19 complementary treated with teicoplanin, used with a double purpose: as empiric antibiotic treatment and as antiviral agent (Tei‐COVID group). A control group untreated with teicoplanin was also enrolled‐The results of this study showed that teicoplanin does not impact on the crude mortality in critically ill COVID‐19 patients: the primary outcome of the study failed due to lack of statistical significance despite mortality being lower in the Tei‐COVID group than in the control group (35.2% vs. 42.8%)‐On Day 14 from the ICU hospitalization, viral clearance was achieved in 64.7% patients of Tei‐COVID group and 57.1% of control group, without statistical difference.‐Serum C‐reactive protein level was significantly reduced in Tei‐COVID group compared to control group. No statistically significant differences were observed for white blood cells and lymphocytes counts, kidney and liver function, PO2/FiO2 and weaning from mechanical ventilation between the two groups at day 8.‐ A possible explanation for these findings is that the antiviral activity of a drug is considered more effective at the onset of disease when viral replication and direct viral damage are still significant. As the disease progresses (the study enrolled critically ill patients), the damage is progressively sustained by pathogenic mechanisms not directly correlated with the presence of the virus, thus reducing the potential therapeutic role of antivirals at this stage.

Amaç: İmplante edilen kardiyoverter defibrilatörler (İKD) uygun hastalarda ani ölüm riskini azaltmaktadır. Ancak İKD şokları ile artmış morbidite ve mortalite arasında ilişki olduğu düşünülmektedir. Çalışmamızda son zamanlarda kardiyak olayları öngörmede sıklıkla kullanılan ekokardiyografik bir ölçüm olan Tei indeksinin İKD şokları ile ilişkisini inceledik. Yöntem: Uygun endikasyonla İKD implante edilen hastaların retrospektif olarak bazal özellikleri ve iki yıllık cihaz takipleri incelendi. İKD şoku alanlar ve İKD şoku almayanlar olarak iki grup oluşturuldu. Bu gruplar bazal özellikleri ve Tei indeksi açısından karşılaştırıldı. Bulgular: Çalışma popülasyonumuzdaki kalp yetersizliği hastalarının İKD implantasyonunu takip eden iki yıl içerisinde hiç şok almayanlara göre ortalama Tei indeksleri anlamlı şekilde daha yüksek saptandı (0.70±0.10 vs 0.56±0.10, p

Prognosis of patients with light-chain cardiac amyloidosis (AL-CA) is poor. Speckle tracking imaging (STI) derived longitudinal deformation parameters and Doppler-derived left ventricular (LV) Tei index are valuable predictors of outcome in patients with AL- CA. We estimated the prognostic utility of Tei index and deformation parameters in 58 comprehensively phenotyped patients with AL-CA after a median follow- up of 365 days (quartiles 121, 365 days). The primary end point was all-cause mortality. 19 (33%) patients died during follow-up. Tei index (0.89 ± 0.29 vs. 0.61 ± 0.16, p < 0.001) and E to global early diastolic strain rate ratio (E/GLSRdias) were higher while global longitudinal systolic strain (GLSsys) was lower in non-survivors than in survivors (all p < 0.05). Tei index, NYHA functional class, GLSsys and E/GLSRdias were independent predictors of all-cause mortality risk, and Tei index ≥0.9 (HR 7.01, 95% CI 2.43- 20.21, p < 0.001) was the best predictor of poor outcome. Combining Tei index and GLSsys yielded the best results on predicting death within 1 year (100% with Tei index ≥0.9 and GLSsys ≤13%) or survival (95% with Tei index ≤0.9 and GLSsys ≥13%). We conclude that 1-year mortality risk in AL-CA patients can be reliably predicted using Tei index or deformation parameters, with combined analysis offering best performance.

Background: The literature has recorded changes in ECG, cardiac morphology in male alcoholics is known by the term "Holiday heart syndrome" with normal heart function. Tei Chuwa devised and published in1995 an index of myocardial performance (the Tei index) that evaluates the LV systolic and diastolic function in combination. To assess cardiac morphology and function through Tei index in male alcoholics, we conducted this study with the following objectives: identify of cardiac morphology and Tei index in male alcoholics, compared with a control group and find out the correlation between left ventricular morphology, Tei index with duration and lifetime intake amount of alcohol. Material and Methods: This study was carried on 100 male subject, 50 alcoholics, mean age 45.50 ± 7.78 and 50 healthy male non-alcoholics with similar age. They are all under echocardiography to measure left ventricular morphology, conventional Doppler Tei index and tissue Doppler Tei indexes. Results: Morphological parameters were significantly greater in alcoholics than in controls: VLTd (9.56 ± 1.64 vs 8.52 ± 0.83), TSTTd (9.29 ± 1.64 vs 8.75 ± 1.10), LVMI (89.82 ± 29.29 vs 77.42 ± 12.67). There were significant differences between the groups of alcoholics and the control subjects with respect to conventional Doppler Tei index and tissue Doppler Tei indexes. The left ventricular mass index correlated with lifetime intake amount of alcohol. conventional Tei index had correlation with duration and lifetime intake amount of alcohol. Conclusions: The alcoholics had left ventricular structural changes, compared to controls. Heart function was evalued by Tei index showed abnormal in alcoholics. Keywords: Alcoholic’s heart, Doppler echocardiography, Tei index.

INTRODUCTION: The growing number of heart failure (HF) patients is becoming an important issue in cardiology. B-type natriuretic peptide (BNP) is a recognized marker of HF, including in patients with preserved systolic function. The TEI index is an indicator of left ventricular function. The aim of the study was to evaluate the relationship between BNP serum level, TEI index and the degree of diastolic dysfunction in patients with HF symptoms and preserved systolic function. MATERIAL AND METHODS: Hundred patients with arterial hypertension and preserved systolic function were enrolled in the study. The study group consisted of 51 individuals with impaired diastolic function and HF symptoms. Fourty-nine hypertensive individuals without HF symptoms were assigned to the control group. B-type natriuretic peptide and echocardiographic examination were performed. Patients were divided into 4 subgroups - with normal diastolic function, impaired relaxation, pseudonormalization and restriction. RESULTS: Median value of BNP in patients with normal diastolic function was 28.36 pg/ml, 87.10 pg/ml in patients with impaired relaxation, 212.75 pg/ml and 461.56 pg/ml in the pseudonormalization and restriction group respectively (p < 0.0001). The median value of the TEI index was: 0.386 in patients with normal diastolic function, 0.507 in individuals with impaired relaxation, 0.639 and 0.725 in the pseudonormalization and restriction group respectively. All the differences were statistically significant (p < 0.0001). A significant positive correlation (r = 0.80, p < 0.001) between BNP and the TEI index was found. CONCLUSIONS: In hypertensive patients with HF symptoms and preserved left ventricular systolic function a highly significant increase in BNP serum level and in the TEI index values related to the deterioration of diastolic dysfunction was found.

Objective:Metabolic syndrome (MetS) and arterial systemic hypertension represent important cardiovascular risk factors that determine patient's prognosis. Their impact on global function of right ventricle (RV) is not completely clarified. The aim of our study was to assess the influence of blood pr

Sacubitril/Valsartan is an angiotensin receptor neprilysin inhibitor (ARNI) approved for treatment of heart failure (HF). It promotes effects of natriuretic peptides by inhibiting neprilysin with Sacubitril and blocking angiotensin II type 1 receptors with Valsartan. It has been shown to reduce

The Tei index of myocardial performance is a noninvasive echocardiographic parameter that combines systolic and diastolic time intervals to assess global cardiac performance. It was demonstrated to be a reliable indicator of myocardial dysfunction in dogs with varying clinical conditions. Because only a few studies focused on the measurement of the index in healthy dogs, this cross-sectional study was conceived to investigate how it performs in a large population of clinically healthy Beagle dogs. Our results showed no correlation between the index and body weight, heart rate, and several standard echocardiographic measures which are estimates of preload and afterload. There was no difference between de index calculated for males or females. Also, results indicated strong intra-observer and inter-observer correlations. In conclusion, the Tei index was shown to perform independently of loading conditions, besides being a straightforward and easily reproducible parameter. &nbsp, El índice de rendimiento miocárdico es un parámetro ecocardiográfico no invasivo que combina intérvalos de tiempo sistólico y diastólico para evaluar el rendimiento cardiaco total. Se ha demostrado que es un indicador fiable de disfunción miocárdica en perros con diferentes condiciones clínicas. Debido a que pocos estudios se centraron en la medición de este índice en perros sanos, este estudio transversal fue concebido para investigar este rendimiento en una gran población de perros Beagle clínicamente sanos. Nuestros resultados no muestran correlación entre el índice y el peso corporal, la frecuencia cardiaca, y varias medidas ecocardiográficas que son estimaciones estándar de precarga y poscarga. No hubo diferencia entre machos y hembras para el índice calculado. Además, los resultados indicaron notorias correlaciones intraobservador e interobservador. En conclusión, el índice de Tei se mostró como un parámetro independiente de las condiciones de la carga, que además de ser fácil de calcular también es un parámetro de fácil reproducción. &nbsp

Background : Various conventional methods are used for functional evaluation and risk stratification in heart failure. A combined index of global myocardial performance called the Tei index has been described. The aim of this study was to evaluate the correlation of the Tei index with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. Methods : Fifty-five subjects with hypertensive heart failure and 30 controls were examined, a clinical history was taken, and echocardiography was performed on them. The subjects were categorised into four groups based on their ejection fraction (normal ejection fraction, mild, moderate and severe heart failure). The Tei index was calculated as the sum of the isovolumic relaxation and contraction time, divided by the ejection time. Statistical analysis was done using SPSS 16.0. Results : The Tei index was significantly higher among subjects with hypertensive heart failure compared with the controls (0.91 ± 0.33 vs 0.28 ± 0.16, p < 0.005). The Tei index also increased with the severity of the heart failure and was inversely correlated with ejection fraction (r = -0.697, p < 0.001) and fractional shortening (r = -0.580, p = 0.001). It was directly correlated with mitral E/A ratio (r = 0.246, p = 0.030), left ventricular internal diastolic dimension (r = 0.414, p = 0.002), left ventricular internal systolic dimension (r = 0.596, p < 0.001) and deceleration time (r = 0.219, p = 0.032). Conclusion : The Tei index correlated significantly with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. It can be used as a risk-stratification index similar to other traditional indices of systolic and diastolic function.

Background: The myocardial performance index (MPI), also known as the Tei index, was introduced by Tei et al. to evaluate cardiac function in adults with dilated cardiomyopathy. This index is defined as the sum of isovolumic contraction time (ICT) and isovolumic relaxation time (IRT), divided by ejection time (ET). Objectives: To determine the correlation between pulsed Doppler (PD)- and tissue Doppler imaging (TDI)-derived Tei indices in fetuses. Patients and Methods: Right and left ventricle PD and TDI echocardiographic data were obtained from 59 fetuses (11 pregnant women who were positive for anti-SSA-Ro or anti-SSB-La antibodies, 18 women who were referred due to dysrhythmia, and 30 women who had normal clinical findings). Results: Mean fetal gestational age was 27 ± 6.4 weeks. Mean PD Tei index of the mitral and tricuspid valve was 0.58 ± 0.05 and 0.53 ± 0.08, respectively. Mean TDI indices for the mitral and tricuspid valve were 0.56 ± 0.09 and 0.55 ± 0.08, respectively. There were no significant differences between mitral and tricuspid PD- and TDI-derived Tei indices (P = 0.87, P= 0.21), but the Bland-Altman diagrams showed no fine agreement between the indices (the mean difference ± 1 standard deviation of the right ventricular PD- and TDI-derived Tei indices was 0.24 ± 0.02 and 0.29 ± 0.04 for the left ventricle). There were no significant differences in PD- and TDI-derived Tei indexes between groups of evaluated fetuses (Mitral valve: PD-Tei P=0.69, TDI-Tei P=0.49; Tricuspid valve: PD-Tei P=0.41, TDI-Tei P=0.36). Conclusions: Although the mean values of the two indices did not differ significantly, the TDI-derived and PD-derived Tei indices did not have fine agreement.

Background: Myocardial infarction (MI) results in impairment of left ventricular (LV) systolic and diastolic functions to various degrees. The tissue Doppler image derived Tei index (TDI-Tei index) has recently been used to assess LV function, and like the conventional Tei index, it was also found to be useful for global function. There are a small number of studies which apply TDI-Tei index to assess regional function and whether it varies according to the degree of changes in wall motion in various LV segments. Objectives: This study was conducted to assess the changes of segmental myocardial Tei index by TDI according to the degree of changes of wall motion in the patient with acute ST-segment elevation myocardial infarction (STEMI) and its correlation with Tei index derived by conventional Doppler. Patients and methods: This study was carried out on thirty patients with acute STEMI selected from Coronary Care Unit, Cardiology Department, Mansoura Specialized Hospital, Mansoura University, Egypt. The study group was subjected to clinical assessment, electrocardiography (ECG), routine laboratory profile and Doppler echocardiography (conventional and pulsed wave tissue Doppler imaging “PW-TDI”). Tei index was calculated from the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT), divided by ejection time (ET) which were measured from pulsed wave Doppler imaging of the trans-mitral inflow and LV outflow tracts. Myocardial velocities and TDI-Tei index were measured at basal and mid-segments of LV walts from apical 4, 2 and 5-chamber views using 16-segment model. Average values of myocardial velocities and TDI-Tei indices were obtained from normal, hypokinetic and akinetic segments then compared. Results: The mean values of left ventricular ejection fraction (LVEF), mitral E/A ratio and conventional Tei index were 51.83 ± 5.15%, 1.18 ± 0.15 and 0.63 ± 0.07 ms, respectively. Segmental myocardial TDI-Tei index was correlated positively with conventional Tei index (r = 0.648, P

Despite normal indices of left ventricular (LV) chamber function, impaired diastolic and systolic function are thought to coexist in hypertensive patients. The aim of this study was to investigate the effects of short-term manidipine therapy on LV global function in Chinese patients with hypertension using the tissue Doppler imaging (TDI) Tei index. Forty-eight patients with mild to moderate essential hypertension underwent a 2-week placebo run-in period, then received 10 to 20 mg/day of manidipine orally for 8 weeks. At the end of the placebo period and treatment, patients were examined by echocardiography. Twenty-five healthy patients were recruited and also underwent an echocardiography study. The mitral annular motions at the lateral, septum, inferior, and anterior sides were recorded. The TDI Tei index was calculated as a diastolic time interval measured from the end of a late diastole to the origin of an early diastole (a) minus systolic peak velocities duration (b) divided by b, which is the Tei index: (a-b)/b. The Tei index was significantly higher in the hypertensive group. After treatment, the Tei index was significantly lower without obvious changes in the transmitral inflow velocity. Moreover, changes in the Tei index showed no correlation with changes in blood pressure.