CAN MYOCARDIAL PERFORMANCE INDEX BE MEASURED BY M-MODE COLOR TISSUE DOPPLER THROUGH THE AORTIC VALVE (PRELIMINARY RESULTS)

Andrey IvAnov1, nIkolAy runev1, emIl mAnov1, elIsAvetA levunlIevA2, AsyA tAchevA3

1Department of Internal Diseases "Prof. St. Kirkovich", Medical University, Sofia, Bulgaria - 2 Department of Pediatric Cardiology, National Heart Hospital, Sofia, Bulgaria - 3Our Lady of Lourdes Hospital, Drogheda, Ireland

 Introduction: Myocardial performance index (MPI) (the sum of isovolumic contraction [IVCT] and isovolumic relaxation [IVRT] divided by ejection time [ET]) is a useful method of left ventricular function assessment. MPI can be calculated based on measurements of left ventricular intervals by pulsed wave Doppler, pulsed wave tissue Doppler [pw TDI], color tissue Doppler [c TDI], M-mode color TDI through the anterior mitral leaflet, etc.

Aim: The aim of our study is to test a possible method of LV intervals measurement and MPI calculation, namely M-mode color TDI through the aortic valve.

Materials and methods: Eighty four (84) subjects, including 37 patients with arterial hypertension (AH), 21 patients with cor- onary artery disease (CAD) and 26 healthy subjects were studied. In all participants IVCT, ET and IVRT were measured using four different echocardiographic methods: 1) pw Doppler, 2) pw TDI, 3) M-mode color TDI through the anterior mitral leaflet, and 4) M-mode color TDI through the aortic valve. MPI based on these four methods of measurement was calculated. MPI by M-mode color TDI through the aortic valve was assessed in two variants (MPIAO1, MPI using the two phases of IVCT, and MPIAO2, MPI using only the second phase of IVCT).

Results: MPIAO1 and MPIAO2 showed good correlation with the three reference methods of measurement used. The highest corre- lation was found between MPIAO2 and MPI by M-mode TDI through the anterior mitral leaflet (rs=0.848, P<0.001) in coronary artery disease patients.

Conclusion: Calculation of MPI based on M-mode TDI through the aortic valve could be a useful method in comprehensive echocardiographic evaluation. It could be used for current assessment of the patients and for their follow-up.