A combined myocardial performance index (isovolumic contraction time plus isovolumic relaxation time divided by ejection time, 'Tei-Index') has been applied in the echocardiographic evaluation of patients with dilated cardiomyopathy (DCM). N-terminal pro brain natriuretic peptide (NTproBNP) is released from the left ventricular (LV) in response tomyocite stretch and is a powerful prognostic marker for heart failure.
Aim: To assess the correlation between Tei index and NTproBNP level in patients with DCM.
Methods: Conventional echocardiography were performed in 50 consecutive patients with DCM, in sinus rhythm, concomitant with NTproBNP determination. Patients with paced rhythm and creatinine clearance < 40 mL/min were not included. Tei index was calculated.
Results: Simple regression analysis demonstrated a statistically significant linear correlation between NTproBNP and Tei index (r = 0.70, p < 0,001). NTproBNP had weaker relationship with pulmonary artery systolic pressure, indexed left atrial (LA) volume, LA volume, LV ejection fraction, early diastolic transmitral velocity (E) and no relationship with LA diameter, mitral E deceleration time, LV end-diastolic diameter. The area under the ROC curve for prediction of NTproBNP levels > 900 pg/mL was maxinal (0.76) for Tei index. The optimal Tei index cut-off for prediction of NTproBNP levels > 900 pg/mL was 0.77 (sensitivity = 84%, specificity = 82%).
Conclusions: Tei index strongly correlates with NTproBNP in patients with DCM in sinus rhythm, and can be a simple and accurate predictor of the serum NTproBNP level.