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Non-invasive prediction of ST elevation myocardial infarction complications by left ventricular Tei index
Nasir Rahman1, Khawar Abbas Kazmi, Muniza Yousaf
1Department of Cardiology, Aga Khan University, Karachi.
Insights
The Tei index can help predict cardiac complications after ST-elevation Myocardial Infarction (STEMI). An elevated Tei index in STEMI patients indicates a higher risk of developing complications within 30 days.
Area of Science:
- Cardiology
- Echocardiography
- Clinical Prediction
Background:
- ST-elevation Myocardial Infarction (STEMI) is a critical condition with significant morbidity and mortality.
- Early identification of patients at high risk for complications is crucial for timely intervention.
- The Tei index, a measure of myocardial function, has emerged as a potential prognostic marker.
Purpose of the Study:
- To investigate the association between the Tei index and the occurrence of cardiac complications in patients with STEMI.
- To evaluate the predictive accuracy of the Tei index for adverse cardiac events following STEMI.
Main Methods:
- A prospective study of 202 adult patients with first STEMI.
- The Tei index was calculated using pulsed Doppler echocardiography.
- Cardiac complications within 30 days of STEMI onset were prospectively monitored.
Main Results:
- 60% of STEMI patients experienced cardiac complications.
- Patients with complications had a significantly higher Tei index (0.66 ± 0.13) compared to those without (0.30 ± 0.10, P < .0001).
- A Tei index > 0.40 demonstrated 86% sensitivity, 82% specificity, and 83% accuracy in predicting complications.
Conclusions:
- The Tei index provides a rapid, practical, and noninvasive method for predicting cardiac complications in STEMI patients.
- Elevated Tei index is a significant predictor of adverse outcomes in the acute phase of STEMI.
Objective:
To investigate association between the Tei index and cardiac complications of ST elevation of Myocardial Infarction.
Patients And Methods:
A total of a 202 adult consecutive patients with first ST elevation MI (STEMI) were studied. Tei index was obtained as: (a _ b)/b, where "a" is the interval between the cessation and onset of mitral flow and "b" is the ejection time of aortic flow measured with the help of pulsed Doppler echocardiography. Subsequent complications, included Death, Congestive Heart Failure (CHF), Cardiogenic shock, Atrial Flutter/ Atrial Fibrillation, Sustained ventricular tachycardia, Advanced Atrio- Ventricular Clock (AV Block), Myocardial Infarction (MI), Readmission (due to any cardiac cause) and Revascuralarization during the 30 days after the onset of Acute STEMI were prospectively evaluated and compared with the initial Tei index at admission.
Results:
Complications were noted in 60% of the patients with acute STEMI. The Tei index was significantly increased for patients with complications compared with those without them (0.66 +/- 0.13 vs. 0.30 +/- 0.10, P < .0001). When Tei index > 0.40 was used for the criteria, the sensitivity, specificity, and overall accuracy to predict subsequent complications were 86%, 82%, and 83%, respectively.
Conclusion:
Tei index allows approximate but quick and practical noninvasive prediction of complications in patients with STEMI.
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