Copyright © 2004 by the European Society of Cardiology.
Clinical research
Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men
a Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Uppsala, Sweden
b Department of Public Health and Caring Sciences, Section of Clinical Nutrition Research, Uppsala University, Uppsala, Sweden
c Department of Medical Sciences, Uppsala University, Uppsala, Sweden
d Astra Zeneca R&D, Mölndal, Sweden
Received 24 June 2004; revised 8 October 2004; accepted 14 October 2004 * Corresponding author. Present address: Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, P.O. Box 609, S-751 25 Uppsala, Sweden. Tel.: +46 18 6117972; fax: +46 18 6117976 (E-mail: johan.arnlov{at}pubcare.uu.se).
See page 2185 for the editorial comment on this article (doi:10.1016/j.ehj.2004.10.017)
AIMS: There is limited data on echocardiographic and Doppler indices of cardiac function as predictors for congestive heart failure (CHF) in the general population. Myocardial performance index (MPI, also denoted TEI-Doppler index) reflects both left ventricular (LV) systolic and diastolic function.
METHODS AND RESULTS: We compared eight different echocardiographic and Doppler indices of cardiac function as predictors of CHF using a population-based cohort of 552 seventy-year-old men without CHF and significant valve disease at baseline (median follow-up time 8.2 years).
In a stepwise multivariable Cox proportional-hazard analysis including the different indices of cardiac function, high MPI (above the 90th percentile of MPI [
0.91]), abnormal LV wall motion score index and a pseudo-normalized/restrictive E/A-ratio pattern independently predicted future CHF morbidity. After adding traditional CHF risk factors (age, previous myocardial infarction, hypertension, diabetes mellitus, hyperlipidaemia, smoking, LV hypertrophy and body mass index) to the above model, only a high MPI remained a significant predictor (hazard ratio 4.72, 95% CI 1.75–12.76, p=0.002).
CONCLUSION: MPI provides important prognostic information for the risk of future CHF, beyond other measurements of cardiac function and traditional heart failure risk factors in elderly men. MPI seems to be a clinically relevant indicator of cardiac function and may prove to be a valuable tool in assessing the risk of future CHF.
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