Open AccessIs Myocardial Performance Index an Independent Echocardiographic Marker of Death in Children with Idiopathic Dilated Cardiomyopathy?
Author(s) -
Azevedo Vitor Manuel P.,
Albanesi Filho Francisco M.,
Santos Marco Aurélio,
Castier Márcia B.,
Tura Bernardo R.,
Amino José Geraldo,
Da Cunha Maria Ourinda Mesquita
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20264
Subject(s) - medicine , cardiology , ejection fraction , body surface area , ventricle , receiver operating characteristic , dilated cardiomyopathy , confidence interval , mitral regurgitation , diastole , cardiomyopathy , multivariate analysis , univariate analysis , heart failure , blood pressure
Background Myocardial performance index (MPI) was reported as a parameter of ventricular systolic and diastolic function, as well as a useful tool to predict the outcome in patients with ventricular dysfunction. Hypothesis To compare MPI with classical echocardiographic parameters as an independent marker of death in children with idiopathic dilated cardiomyopathy (IDCM). Methods Fifty‐five children (13 deaths) underwent 104 echocardiograms from January 1996 to May 2005. Right ventricle (RV) MPI and left ventricle (LV) MPI, and 9 classical echocardiographic parameters (left atrium [LA]/body surface area [BSA], distance between mitral E point and ventricular septum, LV mass/body surface area, RV shortening fraction, LV end‐systolic and end‐diastolic dimensions/body surface area, LV ejection fraction, fiber circumferential shortening velocity, and mitral deceleration time) were compared. Statistical analysis was performed by chi‐square, Pearson's correlation and Student t‐test, Kaplan‐Meier method, Cox's method, and receiver operating curve (ROC). Statistical significance was considered with α< 0.05 and p = 0.80]. Results Univariate analysis showed that all studied parameters were markers of death. There was a high correlation between RVMPI and LVMPI (r = 0.847]–p = 0.0001]); therefore, to avoid bias, RVMPI was discharged from multivariate analysis. In the deceased group, moderate/severe mitral regurgitation was frequent (76.9%; confidence interval [CI[ 95% = 46.2%– 94.9%) and it was considered in multivariate analysis. In Cox's multivariate analysis, LVMPI was the only independent marker of death (p = 0.0213]). The ideal cut‐off was 0.63 with 92.3% sensitivity, 66.7% specificity, and fitted ROC area = 0.918]. Conclusions In children with IDCM, LVMPI is an independent marker of death. Copyright © 2008 Wiley Periodicals, Inc.