Assessment of left ventricle function in aortic stenosis: mitral annular plane systolic excursion is not inferior to speckle tracking echocardiography derived global longitudinal peak strain

Abstract

BackgroundEarly detection of left ventricle (LV) systolic dysfunction is essential for management of patients with aortic stenosis (AS). Two- dimensional speckle tracking derived global longitudinal peak strain (GLPS) is more sensitive than ejection fraction (EF) but requires good image quality and is not easily accessible. The aim of the study was to compare GLPS with traditional echocardiographic parameter- mitral annular plane systolic excursion (MAPSE) in AS.Material and methodsIn consecutive patients with moderate to severe AS and LV ejection fraction ≥ 50% standard echocardiography and two-dimensional speckle tracking echocardiography were performed. Mitral annular plane systolic excursion and global longitudinal peak strain were obtained from apical echocardiographic views.ResultsA total of 82 patients were examined, median age was 68 (60–78), 56% of them were men. There was a positive correlation between aortic valve area index (AVAI) and: MAPSE (r = 0.334, p = 0.002), MAPSE indexed for body surface area- MAPSEI (r = 0.349, p = 0.001) and GLPS (r = 0.342, p = 0.002) but not EF (r = 0.031, p = 0.782). A positive correlation was found between GLPS and MAPSE (r = 0.558, p < 0.001) and between GLPS and MAPSEI (r = 0.543, p < 0.001). All above parameters were significantly lower in symptomatic patients compared to asymptomatic subjects (GLPS: -13.82 ± 3.56 vs. -16.39 ± 3.16%, p = 0.002, MAPSE: 10.49 ± 1.91 vs. 11.95 ± 1.82 mm, p = 0.001 and MAPSEI: 5.66 (4.83-6.6) vs. 6.46 ± 0.97 mm/m2, p = 0.005).ConclusionDespite the development of the modern echocardiographic techniques, mitral annular plane systolic excursion can still be used as a sensitive tool to detect early longitudinal LV systolic dysfunction.

Intraobserver and interobserver reproducibility of M-mode and B-mode acquired mitral annular plane systolic excursion (MAPSE) and its dependency on echocardiographic image quality in children

“…Firstly, MAPSE was decreased even in early stages of twin-to-twin transfusion syndrome before and after laser surgery [ 32 ]. Secondly, MAPSE has been reported not to be inferior to speckle tracking echocardiography derived global longitudinal peak strain for the determination of LV deterioration in aortic stenosis [ 33 ]. Recently, MAPSE was utilized as the functional reference to measure systolic LV longitudinal deformation in a study analyzing tortuosity of the coronary arteries [ 26 ].…”

Longitudinal wall fractional shortening: an M-mode index based on mitral annular plane systolic excursion (MAPSE) that correlates and predicts left ventricular longitudinal strain (LVLS) in intensive care patients

“…Although MAPSE only demonstrates the longitudinal motion of the LV, it was more sensitive than LVEF in detecting early LV dysfunction, such as in hypertensive patients [ 26 , 27 ]. In patients with moderate to severe aortic stenosis, MAPSE was as good as GLS in detecting early LV dysfunction [ 28 ]. Similar to a previous report that showed a positive correlation between MAPSE and longitudinal strain [ 29 ], the present study also found a good correlation between MAPSE sum with LVLS ( r = 0.82).…”

A semiautomatic tracking algorithm for mitral annular plane excursion: A mode for cardiac function evaluation

“…Published by Sciedu Press curves have been shown to accurately reflect the heart condition, [22,23] its measurement requires good quality clips and complex algorithms. The complexity of these algorithms stems from the derivation of the 2D strain curves from tracking the whole left ventricle concomitantly.…”

“…Multidimensional dynamic programing [12] is a more robust technique and much more time consuming method. [22] The computation times reported for multidimensional dynamic programing [12] makes the real time application of this approach more difficult. The algorithm developed here provides results comparable to those obtained with multidimensional dynamic programing with much lower computation times.…”