Study On The Correlation Between Tei Index And Non-ST-segment Elevation Acute Coronary Syndrome

ObjectiveTei indices of patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS) were measured by tissue Doppler imaging and pulsed wave Doppler,toanalyze the difference between two Tei index measurements and discussed the applicationvalue of Tei index in NSTE-ACS patients and their relationship with severity of coronaryartery lesion.MethodsSixty-five patients with first-onset NSTE-ACS who were admitted to our hospital andperformed coronary arteriography (CAG) from June2011to December2012were selectedas the case group, while another31patients excluded coronary heart disease after CAG inthe same period were selected as the control group. All eligible patients underwent bedsideultrasonography6hours after onset, recorded routine ultrasound parameters and Teiindices measured by tissue Doppler imaging (TDI) and pulsed wave Doppler (PW),andthen analyzed the difference between both Tei-index measurements. According to theclassification and diagnostic criteria, NSTE-ACS patients were divided into UA (unstableangina) group and NSTEMI (non–ST-segment elevation myocardial infarction) group andexamined by CAG; All their Gensini scores were recorded to evaluate the application valueof Tei index in NSTE-ACS patients and their relationship with severity of coronary arterylesion.Results(1) For eligible UA group, NSTEMI group and Control group,no significantdifference in basic indices (age and hypertension) and routine ultrasound parameters wasfound among the three groups.(2) PW-Tei indices in UA group, NSTEMI group and control group were0.47±0.07,0.56±0.07and0.39±0.06, respectively, and there were significant differences among the three groups (P=0.000); TDI-Tei indices in these three groups were0.49±0.08,0.57±0.07and0.40±0.06, respectively, and the differences were also statistically significant(P=0.000).(3) Combined NSTE-ACS patients’ PW-Tei and TDI-Tei indices, total PW-Teiindices and total TDI-Tei indices were0.47±0.10and0.48±0.10, respectively, no statisticaldifference was found between the two groups (P=0.321); Pearson correlation coefficientshowed that total PW-Tei indices were highly correlated with total TDI-Tei indices(r=0.849, P<0.001).(4) NSTE-ACS patients’ Tei indices were well correlated with their severity ofcoronary artery lesion (Gensini score); And the correlation coefficient of the PW-Tei index,the TDI-Tei index with the Gensini score were0.721,0.832and P=0.000, respectively.(5) Unitary linear recursive analysis showed that the Gensini score was significantlycorrelated with LA, LVDS, LVDD, LVEF, E/A and Tei indices (P<0.01); But in multiplelinear regression analysis, only Tei indices were significant predictive indices of Gensiniscore (r=0.753, P=0.000).(6) TDI-Tei index of0.51being the optimal critical point, the NSTEMI-diagnosedsensibility was83.3%and the specificity was75.8%. In NSTE-ACS, with UA as controlgroup, when the TDI-Tei index was greater than0.56, the NSTEMI-diagnosed positivepredictive value (PPV) was70.4%and the negative predictive value (NPV) was71.5%.Conclusion(1) NSTE-ACS patients’ Tei indices rise, in contrast to UA patients, NSTEMIpatients’ Tei indices rised significantly.(2) Tei indices of both measurements had no significant difference and wellcorrelationd; Patients’ Tei indices can be measured by both measurements.(3) Tei indices may accurately reflect NSTE-ACS patients’ severity of coronary arterylesion, thus predict the types of lesions of patients.