Relationship between the tissue Doppler-derived Tei index and plasma brain natriuretic peptide levels in patients with mitral regurgitation.

Background And Aim Of The Study: The Tei index, obtained from tissue Doppler echocardiography (TDE-Tei index), has emerged as a new parameter that incorporates both systolic and diastolic time intervals to express global ventricular performance. The study aim was to evaluate whether the TDE-Tei index also correlates with left ventricular (LV) systolic and diastolic function and plasma brain natriuretic peptide (BNP) levels and echocardiographic parameters in patients with symptoms of mitral regurgitation (MR).

Methods: Thirty-three patients (17 males, 16 females; mean age 57 +/- 17 years) with isolated organic MR underwent transthoracic echocardiography and tissue Doppler echocardiography, and were also assessed for symptoms. Plasma BNP levels were also monitored. The patients were allocated to two groups, based on a TDE-Tei index cut-off level of 0.51.

Results: Correlations were identified between the TDE-Tei index and LV ejection fraction (LVEF) (r = -0.54), plasma BNP level (r = 0.5), MR index (r = 0.48), MR jet area (r = 0.38), MR effective regurgitant orifice area (r = 0.37), LV end-systolic diameter (r = 0.43), E/Ea (r = 0.41) and NYHA functional class (r = 0.38). However, no correlations were identified with the left atrial area, MR vena contracta width, MR regurgitant volume, MR regurgitant fraction, systolic pulmonary artery pressure, LV end-diastolic dimensions and LV diastolic dysfunction. The mean values of the TDE-Tei index were 0.40 +/- 11, 0.44 +/- 11 and 0.53 +/- 16 in MR patients in NYHA classes I, II and III, respectively.

Conclusion: In patients with isolated organic MR, the TDE Tei index was found to correlate well with LVEF and plasma BNP levels, and thus may be considered as a new echocardiographic parameter for the assessment of global ventricular function during patient follow up.