Increased Tei index suggests absence of adequate coronary reperfusion in patients with first anteroseptal acute myocardial infarction

Circ J. 2006 Mar;70(3):248-53. doi: 10.1253/circj.70.248.

Abstract

Background: The estimation of coronary reperfusion in acute myocardial infarction (AMI) is important. The left ventricular (LV) Tei index is a noninvasive and sensitive parameter expressing overall LV function. We hypothesized that patients without good coronary reperfusion have worse LV function with a higher or worse Tei index compared to those with good reperfusion.

Methods and results: In 85 patients with first anteroseptal AMI, without other cardiac lesions such as prior myocardial infarction, LV hypertrophy or valvular disease, the Tei index was measured using Doppler echocardiography immediately after patients' arrival to the hospital, and the Thrombolysis in Myocardial Infarction (TIMI) grade was evaluated through subsequent coronary angiography. The Tei index was significantly greater in patients who did not have TIMI score of 3 compared to those with a TIMI of 3 (0.60+/-0.13 vs 0.46+/-0.06, p<0.0001). A Tei index >0.50 as the criteria for the absence of TIMI 3 had the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 75, 86, 94, 54 and 78%, respectively.

Conclusion: An increased Tei index suggests the absence of adequate coronary reperfusion in patients with first anterior AMI without other lesion.

MeSH terms

  • Acute Disease
  • Aged
  • Coronary Angiography
  • Coronary Circulation*
  • Coronary Vessels / pathology
  • Coronary Vessels / physiology*
  • Echocardiography, Doppler
  • Female
  • Heart Function Tests
  • Heart Septum / pathology
  • Heart Septum / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology*
  • Myocardial Reperfusion*
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ventricular Dysfunction, Left / physiopathology*