Effect Of Preload On Different Originated Tei Index Evaluating Left Ventricular Function

Objective: To evaluate the change of the Tei index which is obtained by different methods after the opteration of the simple VSD and PDA patients.additionally,to identify the associated factors related with Tei index.to guide the clinical application of the Tei index.Methods:Paticipants consisted of 32 simple VSD patients and 27 simple PDA patients excluded of any other diseases by physical examintation and electrocardiogram and x-ray. Patients were suggested echocardiography before and one week after the surgerys. Parameters such as Left ventricular ejection fraction(LVEF),Fractional shortening(FS),Left ventricular end-diastolic dimension(LVEDD),Left ventricular end-systolic dimension(LVEDS),Heart rate(HR) and Aortal velocity peak(Vp) were measured.further more ,the Tei index which is originated from Pulse-wave Doppler(PW) and Tissue-Doppler Imaging(TDI) were also calculated under ECG monitoring.Pulsed Doppler study of transmitral inflow was made placing the sample between the tips of the mitral leaflets in the four chambers view and"a"omterval was measured between cessation and onset of the mitral inflow.Pulsed Doppler study of left ventricular(LV) outflow was made placing the sample just below the aortic valve in the five chambers and"b"interval was measured between onset and cessation of the LV outflow . Intervals conventional Tei index was obtained and calculated as (a-b)/b.Pulsed wave TDI was performed at septal mitral annulus and lateral mitral annulus.TDI isovolumic contraction time(ICT) was measured between cessation of Aa wave and onset of Sa wave;TDI ejection time (ET) was obtained between onset and cessation of Sa wave;TDI isovolumic relaxation time(IRT) was obtained between cessation of Sa wave and onset of Ea wave.TDI-Tei was calculated as (ICT+IRT)/ET.Results: EF,Vp,LVEDD,LVEDS and HR decended extently,while Tei index tended to another direction. the Tei index,generally speaking,the TDI-Tei is higher than PW-Tei,and there is a significant correlation between PW-Tei and TDI-Tei.especially the TDI-Tei signicantly increased after the surgery in patients with simple VSD or PDA,and the difference was signicant(P<0.01) ,furthermore,the change of TDI-Tei is seemed to be more related with defect bore(VSD) or patent bore(PDA) than PW-Tei.Conclusion: Either PW-Tei index or TDI-Tei index increased significantly after the surgery; compared to PW-Tei, the change of TDI-Tei index seemed to be more related with the defect bore or patent bore,so, both PW-Tei and TDI-Tei were affected by a cute preload changes. It is necessary to consider the preload changes when we use the Tei index for evaluating the ventricular function.