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Tissue Doppler septal Tei index indicates severity of illness in pediatric patients with congestive heart failure

Aura A Sanchez Mejia1, Kathleen E Simpson, Charles F Hildebolt

  • 1Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8116, St. Louis, MO, 63110, USA, Sanchez_A@Kids.wustl.edu.

Pediatric Cardiology
|September 25, 2013
PubMed

Insights

The Tissue Doppler Imaging (TDI) Tei index effectively indicates disease severity in pediatric heart failure patients. This method shows promise for assessing pediatric heart failure, potentially outperforming standard echocardiography.

Area of Science:

  • Cardiology
  • Pediatric Medicine
  • Medical Imaging

Background:

  • The Tei index, a measure of cardiac function, is a known predictor of outcomes in adult heart failure.
  • Tissue Doppler Imaging (TDI) offers a potential advantage over standard echocardiography for Tei index measurement in children due to reduced heart rate variability influence.

Purpose of the Study:

  • To investigate whether the TDI Tei index can accurately reflect the severity of illness in pediatric heart failure patients.
  • To compare the predictive capabilities of the TDI Tei index with standard echocardiographic parameters and brain natriuretic peptide (BNP) in assessing disease severity.

Main Methods:

  • Prospective enrollment of 25 pediatric heart failure patients.
  • Severity of illness defined by listing for heart transplantation or death.
  • Analysis of baseline demographics, BNP, standard echocardiographic, and TDI-derived parameters.
  • Multivariate regression and receiver operating characteristic (ROC) curve analysis to identify predictive indicators.

Main Results:

  • Forty percent (10 of 25) of patients were listed for heart transplantation; no deaths occurred.
  • Standard echocardiography identified shortening fraction as the best predictor of transplant listing (R(2) = 0.32).
  • TDI parameters, specifically age and the septal Tei index, formed a superior predictive model for transplant listing (R(2) = 0.36).
  • The septal Tei index demonstrated strong predictive performance (ROC AUC = 0.84) with optimal sensitivity (100%) and specificity (60%) at values >0.51.

Conclusions:

  • The TDI septal Tei index serves as a significant indicator of disease severity in pediatric heart failure.
  • TDI-derived Tei index measurements may offer advantages over conventional echocardiographic assessments for evaluating left ventricular function in pediatric heart failure.

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