Myocardial performance index by tissue Doppler echocardiography predicts adverse events in patients with atrial fibrillation.

Autor:	Dons M; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., Olsen FJ; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., de Knegt MC; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., Fritz-Hansen T; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., Mogelvang R; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., Alhakak AS; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark., Jespersen T; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen DK-2200, Denmark., Gislason G; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark.; Institution of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen DK-2200, Denmark., Biering-Sørensen T; Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, Post 835, Hellerup, Copenhagen DK-2900, Denmark.; Institution of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen DK-2200, Denmark.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2020 May 01; Vol. 21 (5), pp. 560-566.
DOI:	10.1093/ehjci/jez173
Abstrakt:	Aims: The prognostic value of myocardial performance index (MPI) has not yet been assessed in patients with atrial fibrillation (AF). The aim of this study was to evaluate the prognostic value of MPI by tissue Doppler imaging (TDI) M-mode in AF patients. Methods and Results: Echocardiograms from 210 patients with AF during examination were analysed offline. Patients with known heart failure (HF) were excluded. Time intervals were measured using an M-mode line through the mitral valve leaflets to provide a colour diagram of the mitral leaflet movement so all time intervals could be measured from one cardiac cycle. MPI was calculated as the sum of isovolumic relaxation time and isovolumic contraction time divided by the ejection time [(IVRT+IVCT)/ET]. During a median follow-up of 2.4 years, 84 patients (40%) reached the combined endpoint of major adverse cardiovascular events (MACE), being all-cause mortality, HF, myocardial infarction, or stroke. Increasing MPI was significantly associated with an increased risk of MACE, and the risk increased with 20% per 0.1 increase in MPI [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.10-1.32; P < 0.001]. Increasing MPI was also significantly associated with a lower left ventricular ejection fraction (LVEF) (P < 0.001). Nevertheless, MPI remained an independent predictor even after adjustment for age, sex, diabetes mellitus, left atrial volume, and LVEF (HR 1.12, 95% CI 1.01-1.25; P = 0.038). Conclusion: Increasing MPI was significantly associated with increased risk of MACE and remained an independent predictor after multivariable adjustment. This demonstrates that the MPI obtained by TDI M-mode might be useful in assessing cardiac function in AF patients with ongoing arrhythmia during examination. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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