Effects of valve dysfunction on Doppler Tei index

Background: Recently proposed Doppler Tei index, defined as the sum of isovolumic contraction dine or mitral valve closure to aortic valve opening time and isovolumic relaxation time or aortic valve closure to mitral valve opening time divided by ejection time, is a simple measure which enables noninvasive estimation of combined systolic and diastolic function and prediction of patients' prognosis. However, effects of valve dysfunction on Tei index have not been investigated. This study was designed to compare Tei index before and after surgical valve replacement or repair to evaluate effects of valve dysfunction on Tei index. Methods. Participants consisted of 76 consecutive patients with aortic or mitral valve surgery (26 patients with aortic stenosis [AS], 16 with aortic regurgitation, 17 with mitral stenosis, and 17 with mitral regurgitation). Doppler Tei index was evaluated before and after the surgery by obtaining (a-b)/b, where a is the interval between the cessation and onset of Doppler mitral filling flow and b is the aortic flow ejection time. Results. Tei index significantly increased after surgery in patients with AS (0.38+/-0.07 to 0.49+/-0.06, P<.001), aortic regurgitation (0.60 +/- 0.20 to 0.70 +/- 0.18, P<.01), mitral stenosis (0.34+/-0.03 to 0.39+/-0.04, P<.01), and decreased with no significance in mitral regurgitation (0.50 +/- 0.03 to 0.46 +/- 0.03). Percent change in Tei index after valve surgery was maximal in patients with AS (27 +/- 6 vs 17 +/- 2 vs 16 +/- 6 vs -9%+/- 6%, As vs aortic regurgitation vs mitral stenosis vs mitral regurgitation, P<.001). Conclusion: Tei index significantly changes after valve surgery especially in patients with AS. Considerations for the effects of valve dysfunction on Tei index are required for its application to evaluate ventricular function in patients with valve disease.