Objective: this study was to determine the diagnostic value of Doppler-derived index of combined systolic and diastolic myocardial performance (Tei index) of left heart in adult outpatients above age 60 years with chronic heart failure and preserved left ventricular systolic function.

Methods: 56 patients (27 male/29 female) with chronic heart failure (37 ischemic, 19 hypertensive), age 71,0 ± 6,1 years (range 60-85), mean NYHA functional class 2,16 ± 0,56, with preserved left ventricular systolic function (LV ejection fraction (EF) > 45%) were included. All patients were under optimal therapy with ACE-inhibitor, beta-blockers, diuretics, and digoxin when necessary. 52 age-and-sex matched healthy asymptomatic control participants (26 male/26 female), age 68,7 ± 6,2 years (range 60-83) were studied. Tei index, defined as the sum of isovolumetric contraction and relaxation time divided by ejection time, was measured by using Doppler echocardiography in all subjects.

Results: Tei index was significantly higher in HF patients than in healthy controls (0,60 ± 0,05 vs. 0,50 ± 0,05; P < 0,001). Receiver operating characteristic curve analysis for the Tei index yielded an area under the curve of 0,93 ± 0,02 for separating heart failure and control patients (95% confidence interval 0,89-0,97). Using the Tei index greater than 0,56 as a cutoff, patients above age 60 years with chronic heart failure and preserved left ventricular systolic function were identified with a sensitivity of 86% and a specificity of 83%.

Conclusion: Our findings support that the Tei index is a sensitive parameter of global cardiac function in patients above age 60 years with heart failure and preserved left ventricular systolic function in outpatient clinics. Tei index identified heart failure patients with preserved left ventricular systolic function above age 60 years with a sensitivity of 86% and specificity of 83%.