Differentiation of Left Ventricular Diastolic Dysfunction, Identification of Pseudonormal/Restrictive Mitral Inflow Pattern and Determination of Left Ventricular Filling Pressure by Tei Index Obtained from Tissue Doppler Echocardiography

Background: Tei index obtained from tissue Doppler echocardiography (TDE‐Tei index) has an inherent advantage of recording its systolic and diastolic components simultaneously on the same cardiac cycle. The aims of this study are to evaluate whether TDE‐Tei index also exerts a correlation with left ventricular (LV) systolic and diastolic function and filling pressure and to see whether it can effectively identify the pseudonormal/restrictive mitral filling pattern. Methods: Echocardiographic examination was performed in 243 consecutive patients. These patients were classified into three groups as normal, abnormal relaxation, and pseudonormal/restrictive groups according to the transmitral E/A‐wave velocity (E/A), early diastolic velocity of lateral mitral annulus (Ea) and E/Ea. Results: Standard Doppler indices of LV filling such as E, A, E/A, and E‐wave deceleration time had a bimodal distribution, but Ea decreased and E/Ea and TDE‐Tei index increased progressively with worsening of LV diastolic function. The sensitivity and specificity of TDE‐Tei index >0.51 in the discrimination of pseudonormal/restrictive filling pattern were 85% and 96%, respectively. After stepwise multiple linear regression analysis, TDE‐Tei index had a significant negative correlation with Ea (β=−0.296, P < 0.001) and ejection fraction (β=−0.293, P < 0.001) and positive correlation with E/Ea (β= 0.235, P = 0.001). Conclusions: TDE‐Tei index increased with worsening of LV diastolic function and can effectively identify the pseudonormal/restrictive mitral inflow pattern. It also correlated with the echocardiographic parameters of LV systolic and diastolic function and filling pressure. It suggests that TDE‐Tei index is a simple and feasible marker in assessing global LV function.