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Effects of modulation of left ventricular contractile state and loading conditions on tissue Doppler myocardial performance index

Cannesson, M and Jacques, D and Pinsky, MR and Gorcsan, J (2006) Effects of modulation of left ventricular contractile state and loading conditions on tissue Doppler myocardial performance index. American Journal of Physiology - Heart and Circulatory Physiology, 290 (5). ISSN 0363-6135

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Abstract

The Tei index is clinically useful to quantify left ventricular (LV) function, but it requires sequential Doppler recordings from two different views. A related myocardial performance index (MPI) using tissue Doppler (TD) can be rapidly calculated from a single beat; however, its ability to quantify contractility and the effects of acute changes in loading have not been determined. Our aim was to test the hypothesis that TD MPI can quantify contractile state but is affected by acute alterations in loading, using LV pressure-volume relations in an animal model. Eight dogs were studied by using mitral annular TD, high-fidelity pressure, and conductance catheters. TD MPI was calculated as (a′ - b′)/b′, where a′ was the duration of mitral annular velocity during diastole and b′ was the duration of the systolic wave. End-systolic elastance (E ), the time constant of isovolumic relaxation (τ), and peak positive and negative first derivative of pressure (dP/dt and dP/dt , respectively) were used as measures of LV function. Data were obtained at baseline, at dobutamine and esmolol infusion to alter contractile state, and at inferior vena cava and aortic occlusion to alter preload and afterload. TD MPI decreased from 0.83 (SD 0.19) to 0.62 (SD 0.20) with dobutamine and increased to 1.19 (SD 0.26) with esmolol. TD MPI significantly correlated with dP/dt (r = -0.76), E (r = -0.68), dP/dt (r = 0.82), and τ (r = 0.78); however, it was affected by acute decreases in preload [from 0.83 (SD 0.19) to 1.09 (SD 0.36)] and acute increases in afterload [to 1.23 (SD 0.17)]. All the above increases and decreases and r values were significant (P < 0.05 vs. baseline). In conclusion, TD MPI can rapidly quantify alterations in LV contractile state but is affected by acute alterations in preload and afterload. Copyright © 2006 the American Physiological Society. es max min max es min


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Cannesson, M
Jacques, D
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Date: 1 May 2006
Date Type: Publication
Journal or Publication Title: American Journal of Physiology - Heart and Circulatory Physiology
Volume: 290
Number: 5
DOI or Unique Handle: 10.1152/ajpheart.01090.2005
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0363-6135
PubMed ID: 16361366
Date Deposited: 05 Apr 2012 21:37
Last Modified: 30 Mar 2021 14:56
URI: http://d-scholarship.pitt.edu/id/eprint/11590

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