HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thorsten Kramm Eckhard Mayer Hellmut Oelert Juergen Meyer Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Menzel, T. Articles by Meyer, J. Search for Related Content PubMed PubMed Citation Articles by Menzel, T. Articles by Meyer, J. Related Collections Great vessels

Ann Thorac Surg 2002;73:762-766
© 2002 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Assessment of cardiac performance using Tei indices in patients undergoing pulmonary thromboendarterectomy

^a Second Medical Clinic (Department of Cardiology), Johannes Gutenberg- University, Mainz, Germany
^b Clinic for Cardiothoracic and Vascular Surgery, Johannes Gutenberg- University, Mainz, Germany

Accepted for publication November 15, 2001.

* Address reprint requests to Dr Menzel, Weichselstrasse 14, D-81677 Munich, Germany
e-mail: menzel{at}mail.uni-mainz.de

Background. This study was designed to evaluate left and right ventricular performance using Tei indices in patients with severe chronic thromboembolic pulmonary hypertension undergoing pulmonary thromboendarterectomy (PTE). The Doppler-derived indices are easily measurable indicators of ventricular function based on nongeometric assessment, which helps overcome some of the difficulties entailed in the geometric assessment of left ventricular (LV) and right ventricular (RV) function in pulmonary hypertension.

Methods. The indices were derived for 24 patients (aged 54 ± 14 years) before and after PTE. Calculation of these indices was based on the duration of two time intervals using the formula (A - B)/B, where A is the interval between cessation and onset of mitral inflow (or tricuspid inflow) and B is LV or RV ejection time. In addition, LV and RV end-diastolic and end-systolic chamber areas were determined using two-dimensional echocardiography, and systolic function was calculated. Mean pulmonary artery pressure was determined invasively.

Results. PTE led to a significant reduction of mean pulmonary artery pressure (46 ± 10 versus 25 ± 6 mm Hg; p < 0.05). LV and RV indices were abnormally high before surgery, declined significantly afterwards, and then almost matched normal values (0.61 ± 0.26 versus 0.37 ± 0.18; p < 0.05 and 0.55 ± 0.22 versus 0.37 ± 0.13; p < 0.05). Geometric assessment of the left and right ventricle also showed impaired systolic function before PTE, with significant improvement after surgery.

Conclusions. LV and RV Tei indices allow a quantitative assessment of ventricular function in patients undergoing PTE. Lower indices after surgery reflect an improvement of the previously impaired cardiac function. Our results emphasize the value of PTE in the treatment of chronic thromboembolic pulmonary hypertension.

This article has been cited by other articles:

				H. J. Reesink, J. T. Marcus, I. I. Tulevski, S. Jamieson, J. J. Kloek, A. V. Noordegraaf, and P. Bresser Reverse right ventricular remodeling after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: Utility of magnetic resonance imaging to demonstrate restoration of the right ventricle J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 58 - 64. [Abstract] [Full Text] [PDF]

				G. Ramakrishna, J. Sprung, B. S. Ravi, K. Chandrasekaran, and M. D. McGoon Impact of Pulmonary Hypertension on the Outcomes of Noncardiac Surgery: Predictors of Perioperative Morbidity and Mortality J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1691 - 1699. [Abstract] [Full Text] [PDF]

				F. Rademakers Echocardiographic volumetry of the right ventricle Eur J Echocardiogr, January 1, 2005; 6(1): 4 - 6. [Full Text] [PDF]

				Y. Allemann, M. Rotter, D. Hutter, E. Lipp, C. Sartori, U. Scherrer, and C. Seiler Impact of acute hypoxic pulmonary hypertension on LV diastolic function in healthy mountaineers at high altitude Am J Physiol Heart Circ Physiol, March 1, 2004; 286(3): H856 - H862. [Abstract] [Full Text] [PDF]

				N. Galie, A. L. Hinderliter, A. Torbicki, T. Fourme, G. Simonneau, T. Pulido, N. Espinola-Zavaleta, G. Rocchi, A. Manes, R. Frantz, et al. Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1380 - 1386. [Abstract] [Full Text] [PDF]