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  • Title: Tei index and neurohormonal activation in patients with incident heart failure: serial changes and prognostic value.
    Author: Mikkelsen KV, Møller JE, Bie P, Ryde H, Videbaek L, Haghfelt T.
    Journal: Eur J Heart Fail; 2006 Oct; 8(6):599-608. PubMed ID: 16469536.
    Abstract:
    BACKGROUND: Natriuretic peptides and Tei index are useful indices for risk stratification in advanced left ventricular dysfunction (LVD). Their role in early stages is less clear. AIMS: In relation to first diagnosis of LVD to assess the relation of plasma B-type-natriuretic peptide (NT-proBNP) with Tei index, assess serial changes in indices, and to assess the value of indices to predict functional status. METHODS: Doppler echocardiography and neurohormonal analysis were performed (n=150). NYHA class was registered. RESULTS: Tei index correlated with p-NT-proBNP (r=0.75, p<0.0001), and changes in indices correlated (r=0.36, p=0.001) in LVD (n=80). No functional improvement (n=47) was related to a median increase in Tei index (-0.2, -0.16; 0.09); an improvement (n=31) to a reduction (0.06; -0.19; 0.35), p=0.02. In the group with functional improvement, more patients had >/=30% reduction in p-NT-proBNP (75% vs. 45%, p<0.01). Addition of NT-proBNP or Tei index to a clinical model, of no functional improvement, improved log-likelihood chi(2) from 9.32 to 20.18 (p=0.001) and 20.67 (p=0.001). CONCLUSION: Tei index and p-NT-proBNP demonstrated a fair correlation. Unimproved NYHA class was related to progressive LVD and might be identified by monitoring Tei index or p-NT-proBNP. Advanced LVD and high pre-treatment p-NT-proBNP levels indicated a potential of improvement in functional status.
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