Clinical and prognostic significance of determining the Tei-index in patients with HIV infection

Abstract

Clarification of the presence of diastolic dysfunction, as a possible onset of chronic heart failure (CHF) with preserved LV ejection fraction, is strategic in determining the management tactics and prognosis of patients with HIV infection. It is known that chronic heart failure in HIV-infected people develops in 16–54 % of cases, accompanying the development of multiple pathologies of the myocardium and endothelium [1]. Currently, modern ultrasound equipment, if equipped with a speckle tracking option, provides ample opportunities for diagnosing CHF with preserved ejection fraction, however, this technology is not yet available in all medical institutions, so it is necessary to search for other opportunities for accurate diagnosis of CHF with preserved ejection fraction ejection
The purpose of this work was to substantiate the use of the Tei index as an optimal and accessible indicator for diagnosing diastolic dysfunction and CHF in people with HIV infection. In a large hospital, a group of 240 patients infected with the human immunodeficiency virus (HIV) was studied over a period of four years. The study was of a one-stage, screening, clinical nature. The Tei index is also found in the literature under the name “myocardial performance index” [2]. The clinical significance of determining the Tei index in determining diastolic dysfunction in patients with HIV infection is higher than the ratio E/e’≥13, which makes this indicator recommended for echocardiography in this cohort of patients as an early marker of diastolic dysfunction and CHF.In HIV-infected patients, an increase in the Tei index of more than 0.41 is associated with the development of left ventricular diastolic dysfunction, hypertrophy, increased volume of the left atrium, pulmonary arterial hypertension, anemia and chronic kidney disease. In patients with HIV infection, with an increase in the Tei Index ≥0.41, the likelihood of developing CHF increases 10.6 times, severe CHF with NT-proBNP≥1500 pg/ml increases 8 times, anemia increases 5.75 times, 3.73 times – coronary artery disease, 3.09 times – chronic kidney disease; 2.86 times for ventricular arrhythmias and 2.29 times for pulmonary arterial hypertension.