Evaluation of left ventricular function using Tei index in patients with preinfarction angina

The study investigated whether preinfarction angina influences left ventricular functions assessed using Tei index, which is an independent predictor for left ventricular dysfunction in acute myocardial infarction.

We studied 96 patients with acute myocardial infarction with ST segment elevation (80 men, 16 women; mean age 57.5+/-9.9 years) who were assigned into 2 groups: with and without preinfarction angina. All patients were serially evaluated by 2-dimensional and Doppler echocardiography on the days 1, 6, and 30, and were followed up for 30 days for incidence of complications.

We observed that Tei index was lower on the days 1, 6 and 30 (0.49+/-0.20 vs. 0.59+/-0.20, p=0.003, 0.46+/-0.20 vs. 0.56+/-0.20, p=0.001, 0.44+/-0.20 vs. 0.53+/-0.10, p=0.01) in patients with preinfarction angina as compared with those without angina. Tei index significantly decreased during follow-up (0.49+/-0.20, 0.46+/-0.20, 0.44+/-0.20; p=0.02) in patients with preinfarction angina, while it did not change significantly in patients without preinfarction angina (p=0.2). Echocardiographically significant improvements were observed in E deceleration time, isovolumic relaxation time and ejection time in all patients, whereas significant improvements in ejection fraction, wall motion score index and isovolumic contraction time were observed only in patients with preinfarction angina during follow-up. Mortality, Killip class >or=2, pericarditis, atrial fibrillation, and left ventricular thrombus were lower in patients with preinfarction angina.

These data indicated that the patients with preinfarction angina had better preserved systolic left ventricular function and Tei index values. Also, it was observed that preinfarction angina may cause earlier and more prominent myocardial functional recovery and confer protection against complications on short-term after first acute myocardial infarction.