Clinical value of myocardial performance index in patients with isolated diastolic dysfunction.

Autor: Fernandes JMG; Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil. jmgfernandes2004@yahoo.com.br., de Oliveira Romão B; Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil., Rivera IR; Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil., Mendonça MA; Faculty of Medicine, Federal University of Alagoas, Av Lourival Melo Mota, sn, Tabuleiro dos Martins, Maceió, 57072-900, Brazil., Costa FA; Federal University of Alagoas, Arapiraca, Brazil., Lira Handro MS; Harmony Medical Center, Maceió, Brazil., Campos O; Federal University of São Paulo, São Paulo, Brazil., De Paola ÂAV; Federal University of São Paulo, São Paulo, Brazil., Moisés VA; Federal University of São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Cardiovascular ultrasound [Cardiovasc Ultrasound] 2019 Aug 13; Vol. 17 (1), pp. 17. Date of Electronic Publication: 2019 Aug 13.
DOI: 10.1186/s12947-019-0167-x
Abstrakt: Aims: The Doppler-derived myocardial performance index (MPI) has been considered as a diagnostic and prognostic Doppler marker for many different clinical conditions. The purpose of this study was to determine the diagnostic accuracy of traditional Pulsed-wave Doppler (PWD-MPI) and Pulsed-wave tissue Doppler imaging (TDI-MPI) and the degree of agreement between these methods in patients with grade-I diastolic dysfunction (DDI) and a normal ejection fraction.
Methods: Forty-seven consecutive ambulatory patients with DDI were compared to 51 healthy subjects with normal echocardiograms. All subjects underwent measurement of time intervals and MPI with PWD and pulsed TDI.
Results: TDI-MPI and PWD-MPI were significantly higher in patients with DDI than in control subjects: 0.49 ± 0.14 vs. 0.40 ± 0.09 (P < 0.001) and 0.45 ± 0.11 vs. 0.37 ± 0.08 (P < 0.001), respectively. Cutoff values of TDI-MPI > 0.42 and PWD-MPI > 0.40 identified DDI subjects, with sensitivities of 74 and 64%; specificities of 61 and 69%; positive likelihood ratios of 1.9 and 2.0; and negative likelihood ratios of 0.42 and 0.53, respectively; no significant difference was noted between the areas under the ROC curves of TDI-MPI and PWD-MPI (P = 0.77). Bland-Altman plots showed wide limits of agreement between these indices: - 0.17 to 0.23 in healthy subjects and - 0.24 to 0.32 in DDI patients.
Conclusion: PWD-MPI and TDI-MPI showed poor clinical agreement and were not reliable parameters for the assessment of left ventricular diastolic function.
Databáze: MEDLINE
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