Evaluation of myocardial function using the Tei index in patients with Kawasaki disease
Evaluation of myocardial function using the Tei index in patients with Kawasaki disease
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DOI：
10.1017/s1047951109991910
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发表时间：
2010-02-01
影响因子：
1
通讯作者：
Nesar, Mir Soleh
中科院分区：
文献类型：
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作者：
Ajami, Gholamhossein;Borzouee, Mohammad;Nesar, Mir Soleh
心肌炎是川崎的一个公认的组成部分，与左心室功能障碍发生在一半以上的患者在急性期的疾病。本研究的目的是使用心肌功能指数（也称为Tei指数）评价这些患者的心肌功能。在一项前瞻性研究中，14例患者接受了超声心动图评价，首先在疾病诊断时，在静脉注射免疫球蛋白治疗前的急性期，然后在免疫球蛋白治疗后2周。我们评估了Tei指数、射血分数、短轴缩短分数以及是否存在瓣膜返流、心包积液或冠状动脉受累。作为对照，我们还评估了22名健康儿童，年龄和性别与研究人群相匹配。与治疗后获得的数据相比，半数患者在急性期左心室Tei指数增加，该指数从0.43 +/- 0.08变为0.35 +/- 0.06（p = 0.003）。5例患者（36%）的右心室指数增加，数值为0.30 +/- 0.05，而不是0.26 +/- 0.04（p = 0.009）。在这些患者中，5例（35.7%）在急性期也出现射血分数和比例缩短分数降低，证实左心室功能障碍。我们的结论是Tei指数，测量收缩和舒张功能，是一个简单，敏感，准确的工具，估计整体心肌功能不全的川崎患者。
Myocarditis is a well-recognized component of Kawasaki disease, with left ventricular dysfunction occurring in more than half of the patients during the acute phase of the disease. The purpose of our study was to evaluate myocardial function in these patients using the myocardial performance index, also known as the Tei index. In a prospective study, 14 patients underwent echocarchographic evaluation, first at the time of diagnosis of the disease, in its acute phase before treatment with intravenous immunoglobulin and then 2 weeks later after treatment with immunoglobulin. We assessed the Tei-index, the ejection fraction, shortening fraction, and the presence of valvar regurgitation, pericardial effusion, or coronary arterial involvement. As a control, we also assessed 22 healthy children, matched for age and sex with the study population. Of the patients, half had an increased left ventricular Tei-index in the acute phase, as compared with the data obtained after treatment, the index changing from 0.43 +/- 0.08 to 0.35 +/- 0.06 (p equal to 0.003). An increased index for the right ventricle was found in 5 patients (36%), values being 0.30 +/- 0.05 as opposed to 0.26 +/- 0.04 (p equal to 0.009). Of the patients, 5 (35.7%) also had decreased ejection fractions and proportional shortening fractions during the acute phase, confirming left ventricular dysfunction. We concluded that the Tei-index, which measures combined systolic and diastolic function, is a simple, sensitive, and accurate tool for estimating global myocardial dysfunction in patients with Kawasaki disease.