© 2005 European Society of Cardiology
Tei index and neurohormonal activation in patients with incident heart failure: Serial changes and prognostic value
a Department of Cardiology, Odense University Hospital Odense, Denmark
b Department of Physiology and Pharmacology, Institute of Medical Biology, University of Southern Denmark Odense, Denmark
c Department of Internal Medicine and Cardiology, Slagelse Hospital Slagelse, Denmark
* Corresponding author. Langelinie 119, DK-5230 Odense M, Denmark. Tel.: +45 65412620. E-mail address: kvm{at}nameplanet.com (K.V. Mikkelsen).
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Abstract |
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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 X2 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.
Key Words: Heart failure • Prognosis • Functional class • Tei index • Natriuretic peptides
Received March 4, 2005; Revised August 1, 2005; Accepted November 28, 2005
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