Influence of Cardiac Function and Loading Conditions on the Myocardial Performance Index　– Theoretical Analysis Based on a Mathematical Model –

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  • Inuzuka Ryo
    Department of Pediatrics, The University of Tokyo
  • Kuwata Seiko
    Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University
  • Kurishima Clara
    Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University
  • Liang Fuyou
    SJTU-CU International Cooperative Research Center, School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University
  • Sughimoto Koichi
    Department of Cardiac Surgery, Royal Children’s Hospital
  • Senzaki Hideaki
    Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University

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Background:The myocardial performance index (MPI) has emerged as a Doppler-derived index for global ventricular function capable of estimating combined systolic and diastolic performance. While several studies have reported its load-dependency, responses of the MPI to various hemodynamic changes have not been fully characterized.Methods and Results:The response characteristics of the MPI were examined and compared with ejection fractions (EF) by changing hemodynamic parameters within the physiological range in a lumped parameter model of the cardiovascular system. At baseline, the MPI was 0.42 and the EF was 0.68. Heart rate increase resulted in a decrease in EF and an increase in the MPI. Reduction in end-systolic elastance decreased EF and increased the MPI. Volume overload and ventricular stiffening did not affect EF but paradoxically reduced the MPI. Increased afterload due to higher systemic resistance resulted in a decrease in EF and increase in the MPI, but afterload increase caused by reduced arterial compliance led to a decrease in both EF and MPI. These MPI characteristics caused paradoxical improvement of the MPI during disease progression of chronic heart failure in a simulation of mitral regurgitation.Conclusions:The MPI is affected by a wider variety of hemodynamic parameters than EF. In addition, it is predicted to decrease paradoxically with volume overload, reduction in arterial compliance, or ventricular diastolic stiffening. These MPI characteristics should be considered when assessing cardiovascular dynamics using this index. (Circ J 2016; 80: 148–156)

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  • Circulation Journal

    Circulation Journal 80 (1), 148-156, 2016

    一般社団法人 日本循環器学会

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