Mitral Annular Plane Systolic Excursion as a Surrogate for Left Ventricular Ejection Fraction

Matos, Jason; Kronzon, Itzhak; Panagopoulos, Georgia; Perk, Gila

doi:10.1016/j.echo.2012.06.011

Cited by 109 publications

(95 citation statements)

References 21 publications

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“…Since mitral annular excursion occurs with longitudinal LV contraction and MAPSE predicts EF [11], the MD variable provides a measure of regional, longitudinal, as well as global LV function. To account for variability in LV size, we normalized the MD variable by the longitudinal LV length.…”

Section: Discussionmentioning

confidence: 99%

A novel and practical cardiovascular magnetic resonance method to quantify mitral annular excursion and recoil applied to hypertrophic cardiomyopathy

Saba

Chung

Bhagavatula

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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BackgroundWe have developed a novel and practical cardiovascular magnetic resonance (CMR) technique to evaluate left ventricular (LV) mitral annular motion by tracking the atrioventricular junction (AVJ). To test AVJ motion analysis as a metric for LV function, we compared AVJ motion variables between patients with hypertrophic cardiomyopathy (HCM), a group with recognized systolic and diastolic dysfunction, and healthy volunteers.MethodsWe retrospectively evaluated 24 HCM patients with normal ejection fractions (EF) and 14 healthy volunteers. Using the 4-chamber view cine images, we tracked the longitudinal motion of the lateral and septal AVJ at 25 time points during the cardiac cycle. Based on AVJ displacement versus time, we calculated maximum AVJ displacement (MD) and velocity in early diastole (MVED), velocity in diastasis (VDS) and the composite index VDS/MVED.ResultsPatients with HCM showed significantly slower median lateral and septal AVJ recoil velocities during early diastole, but faster velocities in diastasis. We observed a 16-fold difference in VDS/MVED at the lateral AVJ [median 0.141, interquartile range (IQR) 0.073, 0.166 versus 0.009 IQR -0.006, 0.037, P < 0.001]. Patients with HCM also demonstrated significantly less mitral annular excursion at both the septal and lateral AVJ. Performed offline, AVJ motion analysis took approximately 10 minutes per subject.ConclusionsAtrioventricular junction motion analysis provides a practical and novel CMR method to assess mitral annular motion. In this proof of concept study we found highly statistically significant differences in mitral annular excursion and recoil between HCM patients and healthy volunteers.

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Section: Discussionmentioning

confidence: 99%

A novel and practical cardiovascular magnetic resonance method to quantify mitral annular excursion and recoil applied to hypertrophic cardiomyopathy

Saba

Chung

Bhagavatula

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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“…We calculated the right ventricular fractional area change from the 4-chamber view (RV FAC). Tricuspid annular plane systolic excursion (TAPSE) was measured using M-mode from the tricuspid lateral annulus and mitral annular plane systolic excursion (MAPSE) was measured using M-mode from the mitral lateral annulus [12]. The gradient between the right atrium and the RV was derived from the peak velocity of the tricuspid regurgitation (TR).…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

Physiological differences between various types of Eisenmenger syndrome and relation to outcome

Moceri

Kempny

Liodakis

et al. 2015

International Journal of Cardiology

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“…However, MAPSE can be easily obtained in patients with poor imaging quality and in dorsal decubitus. Intra-and inter-observer variability is around 5%, which is acceptable [22]. Furthermore, it is an independent predictor of 28-day mortality [23].…”

Section: Mitral Annulus Post Systolic Excursion (Mapse)mentioning

confidence: 80%

Cardiac Ultrasonography in the critical care setting: a practical approach to asses cardiac function and preload for the “non-cardiologist”

Vermeiren¹,

Malbrain

Walpot³

2015

Anaesthesiol Intensive Ther

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Cardiac ultrasonography has become an indispensible tool in the management of hemodynamically unstable critically ill patients. Some consider it as the modern stethoscope. Echocardiography is non-invasive and safe while the modern portable devices allow to be used at the bedside in order to provide fast, specific and vital information regarding the hemodynamic status, as well as the function, structure and anatomy of the heart. In this review, we will give an overview of cardiac function in general followed by an assessment of left ventricular function using echocardiography with calculation of cardiac output, left ventricular ejection fraction (EF), fractional shortening, fractional area contraction, M mode EF, 2D planimetry and 3D volumetry. We will briefly discuss mitral annulus post systolic excursion (MAPSE), calculation of dP/dt, speckle tracking or eyeballing to estimate EF for the experienced user. In a following section, we will discuss how to assess cardiac preload and diastolic function in 4 simple steps. The first step is the assessment of systolic function. The next step assesses the left atrium. The third step evaluates the diastolic flow patterns and E/e' ratio. The final step integrates the information of the previous steps. Echocardiography is also the perfect tool to evaluate right ventricular function with tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging, together with inferior vena cava dimensions and systolic pulmonary artery pressure and right ventricular systolic pressure measurement. Finally, methods to assess fluid responsiveness with echocardiography are discussed with the inferior vena cava collapsibility index and the variation on left ventricle outflow tract peak velocity and velocity time integral. Cardiac ultrasonography is an indispensible tool for the critical care physician to assess cardiac preload, afterload and contractile function in hemodynamically unstable patients in order to fine-tune treatment with fluids, inotropes and/or vasopressors.

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Mitral Annular Plane Systolic Excursion as a Surrogate for Left Ventricular Ejection Fraction

Cited by 109 publications

References 21 publications

A novel and practical cardiovascular magnetic resonance method to quantify mitral annular excursion and recoil applied to hypertrophic cardiomyopathy

A novel and practical cardiovascular magnetic resonance method to quantify mitral annular excursion and recoil applied to hypertrophic cardiomyopathy

Physiological differences between various types of Eisenmenger syndrome and relation to outcome

Cardiac Ultrasonography in the critical care setting: a practical approach to asses cardiac function and preload for the “non-cardiologist”

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