343 Effects of carvedilol on diastolic and systolic function assessed by Doppler tissue imaging during long term follow-up: also good news

Introduction: Tei-index is a new echocardiographic parameter to assess global myocardial performance. It is calculated as the quotient:(isovolumic relaxation time + isovolumic contraction time)/ejection time. The aim of this study was to evaluate the diagnosis role of tei-index in patients with heart failure either with depressed or preserved systolic function. Methods: Forty-nine consecutive patients (mean age 64±18 years) submitted for echocardiographic study due to signs or symptoms of heart failure were included. They were classified into three groups: 18 controls without evidence of heart disease(group A), 15 with heart failure and ejection fraction >45%(group B) and 16 with heart failure and ejection fraction <45% (group C). Tei-index and echocardiographic-derived parameters indicative of left ventricular end-diastolic pressure (Doppler parameters of left ventricular filling, tissue Doppler parameters of the left lateral mitral annulus and pulsed Doppler of the pulmonary veins) were calculated. Results: Tei-index was transformed to its logarithmic value (Ln-T) because it did not follow a normal distribution. By ANOVA test and Scheffe post-test comparison between groups, we found a significant difference between groups (F=18.7; P<0.001). Group B had lower Ln-T value than group C:-0.63±0,36 vs -0.36;P=0.04. The difference was also statistically significant between groups A and B: 1.03±O.35 vs -0.63±0.36;P=0.008 and between groups A and C:-1.03±0.35 vs -0.29±0.36;P<0.0001. There was a significant linear trend between groups. We found a significant linear regression relationship between Ln-T and ejection fraction (r=0.67; P<0.001), but we did not find any relationship between Ln-T and Doppler indexes of left ventricular end-diastolic pressure. Conclusion: Tei-index is a useful parameter to evaluate patients with signs and symptoms of heart failure. This index is higher in patiens with clinical heart failure, even if sistolic function is preserved. The index increases as ejection fraction