Can Tei Index Predict High Syntax Score in Patients with Chronic Coronary Syndrome and Normal Left Ventricular
Hazem Mansour1, Ahmed Ibrahim Nassar1, Walaa Adel Abdel Rehim1
1Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
The Tei index, a noninvasive measure, shows a significant correlation with the SYNTAX score (SS) and left anterior descending artery disease severity in chronic coronary syndrome patients. This suggests its potential as a valuable, radiation-free tool for cardiovascular risk stratification.
Area of Science:
- Cardiology
- Noninvasive Cardiac Imaging
- Risk Stratification
Background:
- Chronic coronary syndrome (CCS) patients categorized as low risk sometimes experience cardiovascular events, while high-risk patients may remain event-free.
- Invasive coronary angiography is standard for assessing coronary artery disease (CAD) severity, with the SYNTAX score (SS) aiding risk stratification in multi-vessel disease.
- There is a need for noninvasive methods to predict CAD severity (reflected by SS) for better risk stratification in CCS patients.
Purpose of the Study:
- To explore the relationship between the Tei index and the SYNTAX score (SS) in patients with CCS.
- To evaluate the Tei index's potential as a noninvasive predictor of CAD severity.
Main Methods:
- The study included 100 patients diagnosed with CCS and normal left ventricular systolic function.
- The relationship between the Tei index (a Doppler-derived cardiac performance index) and the SS was analyzed.
- Statistical analysis assessed the correlation between Tei index, SS, and left anterior descending (LAD) artery involvement.
Main Results:
- A statistically significant positive association was found between the Tei index and the SS (P=0.0001).
- The Tei index also showed a significant correlation with the severity of LAD affection (P=0.0001).
- A Tei index cutoff >0.93 demonstrated 42.4% sensitivity and 86.5% specificity for detecting an SS >22.
Conclusions:
- The Tei index is significantly correlated with the SYNTAX score and LAD affection in CCS patients.
- As a cheap, radiation-free, and noninvasive technique, the Tei index may serve as an additional tool for cardiovascular risk stratification.
- Further research could validate the Tei index for routine clinical use in CCS risk assessment.
Objective:
Some patients who had chronic coronary syndrome (CCS) and were recognized as low risk, however, developed cardiovascular events, whereas others who were categorized as high risk did not develop any cardiovascular events. Invasive coronary angiography is the gold standard tool for the assessment of coronary artery disease (CAD) severity. The SYNTAX score (SS) was recently recognized as an invasive angiographic-guided scoring system used in risk stratification of patients who have more than one-vessel CAD and undergoing revascularization with percutaneous cardiovascular intervention. It has a good predictive value of adverse cardiovascular events. Exploration for unique noninvasive modalities that may help in a better way for risk stratification of CCS patients by predicting the severity of CAD (as reflected by SS) would be of a paramount value. Tei index is a promising modality for that objective, which is a Doppler-derived time interval index that combines both systolic and diastolic cardiac performance.
Methods:
We examined the relationship between the severity of CAD as assessed by the SS and Tei index in 100 patients with CCS and normal left ventricular systolic function.
Results:
All the studied 100 patients had a normal ejection fraction with mean = 58.92 ± 7.88; the mean value of Tei index was 0.84 ± 0.26. There was a statistically significant positive association between Tei index and SS (P = 0.0001); moreover, there was a correlation between left anterior descending (LAD) affection and Tei index (P = 0.0001).The cutoff point of Tei index to detect SS above 22 was >0.93 (with specificity of 86.5% and sensitivity of 42.4%).
Conclusion:
Tei index significantly correlates with SS and LAD affection. Moreover, it is a cheap, radiation-free, noninvasive technique and may be used as a further risk stratification modality beyond others.
More Related Videos
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
08:13In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:29Heart Failure II: Pathophysiology
01:26Coronary Artery Disease II: Pathophysiology