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Controlled Clinical Trial
. 2006 Jan;19(1):21-7.
doi: 10.1016/j.echo.2005.07.010.

Use of myocardial performance index in pediatric patients with idiopathic pulmonary arterial hypertension

Karrie L Dyer  1 , Linda B Pauliks, Bibhuti Das, Robin Shandas, Dunbar Ivy, Elizabeth M Shaffer, Lilliam M Valdes-Cruz
Affiliations
Controlled Clinical Trial

Use of myocardial performance index in pediatric patients with idiopathic pulmonary arterial hypertension

Karrie L Dyer et al. J Am Soc Echocardiogr. 2006 Jan.

Abstract

Background: The myocardial performance index (MPI) correlates with clinical status in adults with idiopathic pulmonary arterial (PA) hypertension (IPAH). This pediatric study used MPI to assess response to bosentan therapy.

Methods: The study included 12 children with IPAH and 12 healthy control subjects. MPI was correlated with catheterization data at initiation of bosentan and at a median follow-up of 9 months. Therapy responders were defined by a greater than 20% decrease in mean PA pressure.

Results: Right ventricular MPI for patients with IPAH was 0.64 +/- 0.30 versus 0.28 +/- 0.03 in control subjects (P < .01). It had a strong correlation with mean PA pressure (R = 0.94; P < .001). Right ventricular MPI decreased significantly in responders (range 20%-44%, mean 25%) with a 5% increase in nonresponders.

Conclusions: Right ventricular MPI in pediatric IPAH correlates with mean PA pressure and response to therapy. This study suggests that this noninvasive Doppler index may be useful to follow up children with IPAH, particularly when tricuspid regurgitation data are insufficient.

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Figures

Figure 1
Figure 1
Calculation of right ventricular (RV) myocardial performance index (MPI). Interval “a” (from onset of isovolumic contraction to onset of diastolic filling) was determined from tricuspid inflow trace (left). Interval “b” (systolic ejection time) was measured from RV outflow trace (right). RV MPI was calculated as: MPI = (a − b)/b.
Figure 2
Figure 2
Difference between right and left ventricular myocardial performance index (MPI) in idiopathic pulmonary arterial hypertension (IPAH) group compared with normal (NL) group (*P < .05).
Figure 3
Figure 3
Right ventricular (RV) myocardial performance index (MPI) correlated with mean pulmonary artery pressure (MPAP) obtained at initial (pre) (A) and follow-up (post) (B) cardiac catheterization.
Figure 4
Figure 4
Bland-Altman plots of intraobserver and interobserver variability indicate good reproducibility over broad range of values.
See this image and copyright information in PMC

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