Index Tei an early marker of left ventricular diastolic dysfunction in persons with cardiac manifestations of connective tissue dysplasia
Abstract
The problem of connective tissue dysplasia (СТD) is of increasing interest to cardiologists. The functional state of the myocardium in minor heart anomalies (MHA), which are recognized as visceral manifestations of СТD, is poorly understood, but can acquire greater clinical significance. The Tei index, being a quantitative indicator of diastolic myocardial function, allows to diagnose structural and functional changes in the heart. Purpose. To determine the diagnostic significance of the Tei index in assessing the performance of LV myocardium in persons with СТD and to choose the optimal method of its measurement. Materials and methods. 32 people with one MHA (group 1) and 45 people with two or more MHA (group 2) aged 20 to 40 years were examined, 30 healthy people were in the control group. The Tei index was measured in three ways: according to the Doppler sonography of a transmitral blood flow (D-EchoCG) and pulsive wave tissue Doppler imaging (TDI) of the lateral (index TeiMFAlat) and medial part (index TeiMFAlat )of the mitral fibrous annulus. Results: the Tei index according to D-EchoCG in groups 1 and2 was 0.48±0.05 conditional units and 0,53±0,07 conditional units, which is higher than in healthy individuals (0.40±0.04 conditional unit, p<0.001). In the calculation mode, TDI showed similar dynamics. In persons with multiple MHA index TeiMFAlat and indexMFAm was the highest, amounting to 0,51±0,09 conditional units and 0,52±0,08 conditional units, respectively, which is significantly higher than in the 1st and control groups. ROC-analysis showed that the most diagnostic value has the method of calculating the index TEI in the mode TDI of the medal part of the MFA. Conclusions: the increase of the index TeiMFAm ≥ 0,46 conditional unit is an early marker of diastolic LV dysfunction in individuals with СТD with a sensitivity of 93.3 % and a specificity of 50 %.
About the Authors
E. V. Fomenko
Federal State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
N. F. Beresten
Federal State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
S. B. Tkachenko
Federal State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
V. N. Kolesnikov
Federal State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
S. N. Romanov
Federal State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
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Review
For citations:
Fomenko E.V., Beresten N.F., Tkachenko S.B., Kolesnikov V.N., Romanov S.N. Index Tei an early marker of left ventricular diastolic dysfunction in persons with cardiac manifestations of connective tissue dysplasia. Medical alphabet. 2018;4(36):42-48. (In Russ.)
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