Performance index of left ventricular myocardium: possible using for evaluation of prognosis in elderly patientswith chronic heart failure
Background. Conventional EchoCG parameters routinely used for evaluation of the heart function have a number of limitations. For this reason, reliable indices for evaluation of LV global performance and prediction of changes in heart failure are being continuously searched for. Aim. To determine an optimum value of LV myocardial performance index (Tei) for prediction of unfavorable outcome in elderly patients with CHF. Materials and methods. The open, prospective study included 97 patients aged 60 to 85 (70.6±6.2) with clinical symptoms of CHF and LV EF of 25 to 64.5 % (mean, 47.3±11.7 %). General clinical examination, ECG, and EchoCG with measurement of the Tei index (ratio of the time interval between the end of transmitral flow (TF) and the start of the next TF to the LV ejection time) were performed. Median follow-up was 2 years. Results. According to results of the ROC curve analysis, the LV EF value for prediction of unfavorable outcome in elderly CHF patients was 49 % or less (sensitivity, 76 %; specificity, 77 %) and the Tei index value was 0.69 or higher (sensitivity, 77 %; specificity, 86 %). The Tei index independently predicted two endpoints (MI and fatal outcome) in elderly patients with CHF. Conclusion. The Tei index of 0.69 or higher was a predictor of unfavorable CHF outcome in patients aged 60 or older.