Can myocardial performance index predict the presence of silent ischemia in asymptomatic type 2 diabetic patients?

Background Coronary artery disease ( CAD ) is an important cause of morbidity and mortality in patients with diabetes. Silent myocardial ischemia ( SMI ) is common in patients with diabetes and is associated with poorer prognosis. Myocardial performance index “Tei index” that reflects both left ventricular ( LV ) systolic and diastolic function. The aim of our study was to test the value of Tei index in prediction of SMI in asymptomatic patients with type 2 diabetes. Patients and Methods Asymptomatic patients with type 2 diabetes were included in our study. We excluded patients with known CAD , previous revascularization, low ejection fraction, or abnormal ECG from the study. All patients had undergone history taking and clinical examination, ECG , echocardiography with measuring of Tei index and Holter monitoring for detecting silent ischemia. Results A total of 200 patients were recruited. We divided our patients into two groups: Group I: 64 patients with SMI , Group II : 136 patients without SMI . There was no significant difference between the two groups regarding clinical and conventional echocardiographic data. Tei index was significantly higher in patients with silent ischemia ( P <.00001). Sensitivity, specificity, positive, and negative predictive values of Tei index ≥0.6 in prediction of Holter detected silent ischemia were 85.9%, 90%, 78.6%, and 88.6%, respectively. We found a significant positive correlation between Tei index and number of ischemic episodes ( r =.366, P =.0029). Conclusion Measuring Tei index is helpful in predicting the presence of silent ischemia in asymptomatic patients with type 2 diabetes.