Normal Values of Left and Right Ventricular Tissue Doppler Imaging Myocardial Performance Index by Age and Gender
Author(s):
Anwar Ashraf M, Bakhsh Abeer*, Tunkle Ammar and Chamsi-Pasha Hassan
The Myocardial Performance Index (MPI) is a validated modality for LV and RV assessment.
Objective: This study evaluates the normal values of MPI by PWD and TDI in males and females across a wide age rage.
Methods: MPI was measured for LV and RV using PWD and TDI in 99 healthy adults, of which 49 were women.
Results: The sample was divided by age into: GI 17-44 years, GII 45-60 years, GIII 61-75 years and GIV >75 years. Mean LV PWD-MPI was 0.5 and LV TDI-MPI for septal/lateral walls 0.384/0.386. Mean LV PWD-MPI for males is [GI 0.53±0.18, GII 0.59±0.13, GIII 0.49±0.23, GIV 0.48±0.27] and females [GI 0.49±0.16, GII 0.54±0.17, GIII 0.45±0.10, GIV 0.47±0.08]. Mean LV TDI-MPI for septal and lateral in males are [GI 0.37/0.31, GII 0.36/0.36, GIII 0.46/0.39, GIV 0.36/0.36] and females [GI 0.37/0.36, GII 0.37/0.42, GIII 0.41/0.42, GIV 0.33/0.45]. There was an excellent correlation between LV TDI-MPI septal and lateral (0.38± 0.13 and 0.39± 0.13; R= 0.337; p= 0.001). There were no significant differences in LV TDI-MPI between males and females for the septal MPI (0.39± 0.15 vs. 0.37± 0.10; P= 0.46) and lower in males than females for the lateral MPI (0.36± 0.12 vs. 0.41± 0.13; p = 0.04). However, the reference value was higher for LV TDI-MPI septal/lateral in GIII 0.46/0.39. The correlation was not significant between LV PWD-MPI and LV TDI-MPI septal = 0.18; p value= 0.078, and between the LV PWD-MPI and LV TDI-MPI lateral = 0.13; p value= 0.22. The Mean RV PWD-MPI was 0.4±0.28. The RV PWD-MPI showed significant variation by age and gender for male/female [GI 0.35±0.23/0.27±0.22, GII 0.26±0.19/0.49±028, GIII 0.51±0.27/0.63±045, GVI 0.47±0.35/0.35±0.17]. The normal RV TDI-MPI was 0.39±0.12 with no significant differences between males and females (0.40± 0.28 and 0.40± 0.26; p = 0.99).
Conclusion: The septal and lateral LV TDI-MPI is well correlated for all the groups in both genders. However, in GIII there is an increase in the LV TDI-MPI. There is significant variation in RV PWD-MPI by gender especially in the in GIII. This variation is not seen by TDI-MPI for the RV.