Changes in Mitral Annular Ascent with Worsening Echocardiographic Parameters of Left Ventricular Diastolic Function

Abstract

Background. While the mitral annular plane systolic excursion (MAPSE) has been suggested as a surrogate measurement of left ventricular ejection fraction, less is known about the relative value of mitral annular ascent (MAa). Methods. Our database was queried for complete transthoracic echocardiograms performed for any clinical indication. Baseline echocardiographic measurements were compared to determine any correlation between MAa and traditional Echo-Doppler echocardiographic measures to characterize left ventricular diastolic dysfunction (LVDD). Results. Patients with normal LV diastolic function were younger (41 ± 13 years) than patients with LVDD (stage 1: 61 ± 13 years; stage 2: 57 ± 14 years; and stage 3: 66 ± 17 years; p = 0.156). LV ejection fraction decreased in patients with stage 2 LVDD (63 ± 17%) and was further reduced in patients with stage 3 LVDD (28 ± 21; p = 0.003). Discussion. While a vigorous MAa excursion was seen in patients with stage 1 LVDD, MAa significantly decreased in stage 2 and stage 3 LVDD patients. Our results highlight the importance of atrioventricular coupling, as MAa motion seems to reflect changes in left atrial pressure. Additional studies are now required to better examine atrioventricular interactions and electromechanical coupling that might improve our assessment of LV diastolic function.

Left Ventricular Diastolic Function Assessment of a Heterogeneous Cohort of Pulmonary Arterial Hypertension Patients

“…Additionally, multiple logistic regression test was performed to determine predictors of abnormal diastolic function. Intra- and inter-observer variability in our echo lab for this patient population has been previously reported [ 25 , 26 ]. A P-value of less than 0.05 was considered statistically significant.…”

Assessment of Mitral Annular Plane Systolic Excursion in Patients With Left Ventricular Diastolic Dysfunction

“…Finally, a linear regression model was obtained to determine the contribution of age and LVEF toward MAPSE and a two-way contour plot was illustrated to better understand such contribution. Reliability of these measurements has already been published [7]. Statistical analyses were performed using SAS software version 9.4 (SAS Institute, Cary, NC, USA), and P values < 0.05 were considered statistically significant.…”

“…Our group has recently highlighted the relationship between MA ascent motion and changes in LA pressure [7]. However, whether this atrio-ventricular coupling was the result of chamber geometry or anatomic continuity was never determined.…”