Impact of preload alterations by haemodialysis on the Tei index: comparison between pulsed flow and tissue Doppler analyses.

Objective: The aim of this study is to evaluate and compare the impact of preload alterations by haemodialysis (HD) on the Tei index obtained by pulsed Doppler echocardiography (PDE-Tei index) and tissue Doppler echocardiography (TDE-Tei index).

Methods And Results: Thirty-eight uraemic patients underwent echocardiography 1 hour before and 1 hour after HD was studied. Before HD, PDE- and TDE-Tei indices had a weak correlation (r = 0.439, P = 0.006). After HD, the correlation became stronger (r = 0.794, P < 0.001). After HD, body weight (P < 0.001), early transmitral filling wave peak velocity (E) (P < 0.00 1), early diastolic mitral annular velocity (Em) (P < 0.00 1), and E/Em (P = 0.00 1) decreased and PDE- (P < 0.00 1) and TDE-Tei indices (P = 0.022) increased significantly. In addition, after HD, body weight reduction had a significant correlation with E decrease and PDE- and TDE-Tei index increase (P < 0.00 1, P = 0.005, and P = 0.016, respectively). A subgroup comparison showed that in patients with body weight reduction < 3 kg, the PDE-Tei index (P = 0.003) increased significantly but TDE-Tei index (P = 0.209) did not change after HD. In patients with body weight reduction > or = 3 kg, both the PDE- and TDE-Tei indices (P = 0.003 and 0.042, respectively) increased significantly after HD.

Conclusions: Both the PDE- and TDE-Tei indices are preload-dependent indicators. However, TDE-Tei index is less preload-dependent and is more accurate in assessing global left ventricular function in patients with body weight reduction < 3 kg after HD.