Correlation of Tei Index Assessed by Different Echocardiographic Methods in Patient with Acute Myocardial Infarction Receiving Different Reperfusion Treatment in comparison with EF and diastolic function

Background: Acute myocardial infarction (AMI) is a common cardiac condition with high morbidity and mortality worldwide. A common complication of AMI is heart failure (HF). HF is the most significant predictor of mortality among AMI patients. So, a significant echocardiographic measurement for post-AMI patient is to assess the left ventricular systolic function via left ventricular ejection fraction (LVEF). As such, Tei index, which simultaneously measures relaxation and contraction velocities, may be of a prognostic importance in those presenting with AMI that may go unmissed with the isolated evaluation of LVEF. Objectives: this work was done to correlate MPI evaluated by different echocardiographic methods in AMI patient receiving different reperfusion treatments. Methods: The was a prospective study which included 60 subjects of both sexes, who were presented to Al-Azhar University Hospitals. They were divided into 2 groups based on the reperfusion strategy, group I that included 31 subjects with 1st attack of acute ST elevation myocardial infarction (STEMI) treated with emergency PCI and group II that included 28 subjects with 1st attack of acute STEMI who underwent fibrinolysis. Results: A highly significant inverse relationship was found between MPI and LV systolic function as the lower the LVEF, the higher MPI and strong correlation between MPI and the killp classification as the higher MPI, the higher the killip class. No significant difference regarding DD, MPI and EF existed in patients presented with acute STEMI and received any one of reperfusion strategies within the first 3 hours according to the method of reperfusion. On the contrary, when the time of revascularization was delayed more than 3 hours, a significant difference was found in MPI and EF regarding the method of revascularization where primary PCI was better than thrombolytic therapy Conclusions: MPI and EF is a covariate that is affected by time and method of reperfusion, so in case the time of reperfusion was less than three hours there was no difference according to the method of reperfusion but when the time of reperfusion delayed for more than three hours PCI was much better in decreasing post MI HF or LV dysfunction than thrombolytic therapy strategy.