748 Peak systolic velocity not Tei index appears to be most reliable to differentiate coronary healthy subjects from those with coronary artery disease

Background: Left ventricular (LV) Tei index that is the ratio of isovolumic times and ejection time has been claimed to be a powerful index of LV performance. Tei index (lower the better; 0.9 being the cut-off) however has never been tested using colour tissue Doppler echocardiography, the modality that has excellent temporal resolution at high frame rates. The main purpose of the study was to investigate whether the index could differentiate coronary healthy from coronary artery disease (CAD). Methods: 17 non-consecutive patients with angiographically (CAG) confirmed CAD and 9 subjects without (No-CAD) were recruited from the stress echo archive. CAG was performed after the subjects were diagnosed as having positive velocity-enhanced dobutamine stress echocardiography (DSE). Digital images were post processed at rest and during peak stress on a GE VIVID system equipped with Echopac software. Isovolumic contraction (IVCT) and relaxation times (IVRT), ejection times (ET) along with isovolumic contraction velocity (IVCV) and peak systolic velocities (PSV) were computed from the 4 basal segments of LV. LV ejection fraction (EF) was estimated by modified Simpson’s approach. Tei index was calculated using the formula (IVCT + IVRT)/ET. Data are expressed as mean ± SD. A p value of 0.05). IVCV did not differ. Similar data were obtained during peak stress, average PSV (cm/s) being the most significant differentiating variable between CAD and No-CAD (7.2±1.3 vs 12.3±1.1; p<0.001). Conclusion: Tei index is feasible using colour tissue Doppler echocardiography. However it does not provide additional information on top of the velocity data, confirming that the latter variable is most reliable to differentiate between CAD and No-CAD. The data explains the excellent concordance between velocity quantified DSE and the CAG-diagnosis of CAD. LV FUNCTION – OTHER