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Kidney function and the prognostic value of myocardial performance index

Nino Emanuel Landler1,2, Rasmus Møgelvang3, Susanne Bro4

  • 1Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. nino.emanuel.landler@regionh.dk.

The International Journal of Cardiovascular Imaging
|January 21, 2021
PubMed

Insights

The myocardial performance index (MPI) predicts cardiovascular events in individuals with reduced estimated glomerular filtration rate (eGFR). This cardiac risk assessment tool is particularly valuable for those with eGFR below 75 mL/min/1.73 m².

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Decreased glomerular filtration rate (GFR) is an independent risk factor for cardiovascular disease.
  • The myocardial performance index (MPI), calculated from isovolumetric relaxation time (IVRT), isovolumetric contraction time (IVCT), and ejection time (ET), predicts cardiovascular events.
  • Assessing cardiac risk in individuals with reduced estimated GFR (eGFR) is crucial.

Purpose of the Study:

  • To investigate the prognostic capability of MPI in assessing cardiac risk within the general population.
  • To determine if MPI's predictive value for cardiovascular events differs between individuals with normal and reduced eGFR.

Main Methods:

  • A prospective cohort study involving 1915 subjects from the general population.
  • MPI was measured using color tissue Doppler imaging (TDI) M-mode.
  • Multivariable adjusted Cox regression models were used to compare prognostic capabilities based on eGFR thresholds (≥75 vs. <75 mL/min/1.73 m²).

Main Results:

  • A significant interaction was found between eGFR and MPI's prognostic capability (p < 0.001).
  • MPI remained an independent predictor of the composite endpoint (heart failure, myocardial infarction, or cardiovascular death) only in participants with eGFR < 75 mL/min/1.73 m² (HR 1.18; 95% CI 1.02-1.38).
  • In subjects with eGFR ≥ 75 mL/min/1.73 m², MPI was not a significant independent predictor (HR 1.14; 95% CI 0.94-1.39).

Conclusions:

  • The myocardial performance index (MPI) demonstrates significant prognostic value for cardiovascular events specifically in individuals with decreased eGFR (<75 mL/min/1.73 m²).
  • MPI may serve as a valuable tool for identifying elevated cardiac risk in the general population with impaired kidney function.
  • Further research could explore integrating MPI into risk stratification protocols for patients with chronic kidney disease.
Keywords:
EchocardiographyEstimated glomerular filtration rateKidney functionMyocardial performance indexTime intervalseGFR

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