Concordance between M-mode, pulsed Tissue Doppler, and colour Tissue Doppler in the assessment of mitral annulus systolic excursion in normal subjects

Ballo, Piercarlo; Bocelli, Arianna; Motto, Andrea; Mondillo, Sergio

doi:10.1093/ejechocard/jen130

Cited by 27 publications

(18 citation statements)

References 21 publications

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“…We found only moderate associations between AVPDm and TDIs, and they may also not be interchangeable, although TDI correlated well with AVPD in healthy individuals [26,48]. Several possible reasons may explain a lack of correlation between TDI and AVPD [23,49,50]. …”

Section: Discussionmentioning

confidence: 79%

Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care

et al. 2011

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IntroductionAssessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE).MethodsFifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI).ResultsEBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ranging from 0.79 to 0.95 (P < 0.01). the Simpson correlations with the other LV parameters showed substantial variation over time, with the poorest results seen for TDIs and AVPDm. The repeatability was best for VTI (interobserver coefficient of variation (CV) 4.8%, and intraobserver CV, 3.1%), and AVPDm (5.3% and 4.4%, respectively), and worst for the Simpson method (8.2% and 10.6%, respectively).ConclusionsEBEF and AVPDm provided the best, and Simpson, the worst feasibility when assessing LV systolic function in a population of mechanically ventilated, hemodynamically unstable patients. Additionally, the Simpson showed the poorest repeatability. We suggest that EBEF can be used instead of single-plane Simpson when assessing LV ejection fraction in this category of patients. TDIs and AVPDm, as markers of longitudinal function of the LV, are not interchangeable with LV ejection fraction.

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Section: Discussionmentioning

confidence: 79%

Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care

et al. 2011

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“…It should also be mentioned that the mean longitudinal displacement in the TCA cohort was at the upper limits of established normal values. 28 Accordingly, we have tried not to imply that tortuosity is associated with “hyperdynamic” longitudinal function; only that it is associated with greater longitudinal function as a proportion of the baseline length. Although angiography and echocardiography were not simultaneously performed, we believe that this is a minor limitation since TCA is likely to develop over years to decades.…”

Section: Discussionmentioning

confidence: 99%

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Oehler

Minnier

Lindner

2017

Journal of the American Society of Echocardiography

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Background The mechanistic basis for tortuosity of the coronary arteries (TCA) is unclear. We hypothesized that the relative degree of systolic longitudinal shortening of the LV which deforms co-axially-oriented coronary arteries is associated with TCA. Methods Adult subjects undergoing coronary angiography and comprehensive echocardiography within 3 months were classified dichotomously as with (n=32) or without (n=42) TCA defined based on number and severity of coronary angles. Systolic LV longitudinal deformation was determined by mitral annular plane systolic excursion (MAPSE) from both B-mode displacement and tissue Doppler time-velocity integral; data were indexed to LV diastolic long-axis length. Results There were no differences between groups with respect to age, gender, hypertension, or coronary artery disease. Patients with TCA had significantly (p<0.01) lower LV mass index and a shorter total LV diastolic long-axis length (8.3±1.9 vs 9.1±2.2 cm, p<0.01). Despite having a shorter length, those with TCA had a greater MAPSE by both methods. MAPSE normalized to diastolic length was significantly greater (p<0.01) in those with TCA, and remained the case after excluding subjects with reduced LV ejection fraction. Multiple linear regression found that lateral annular MAPSE had the largest effect size with a 13-fold increase in likelihood for TCA for every 0.1 of normalized MAPSE. Conclusions TCA is not associated with increased LV mass but rather with smaller hearts that have greater relative longitudinal shortening of the LV. This finding suggests that TCA could represent an adaptive response to longitudinal systolic distortion of co-axially-oriented coronary arteries that dynamically produce shear stresses associated with expansive coronary remodeling.

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“…The two parameters describe different vector components of longitudinal systolic motion. Although TDIs has been described to correlate well with MAPSE in studies with healthy individuals [39,41], they differ in some important aspects [42] as MAPSE measures the entire systolic phase including isovolumetric contraction [15] in contrast to TDIs. In addition a blurred TDI signal can be a confounding factor when measuring the velocity [43] and in these situations MAPSE can be a valuable.…”

Section: Discussionmentioning

confidence: 99%

Mitral annular plane systolic excursion (MAPSE) in shock: a valuable echocardiographic parameter in intensive care patients

Bergenzaun

Öhlin

Gudmundsson

et al. 2013

Cardiovasc Ultrasound

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BackgroundAssessing left ventricular (LV) dysfunction by echocardiography in ICU patients is common. The aim of this study was to investigate mitral annular plane systolic excursion (MAPSE) in critically ill patients with shock and its relation to LV systolic and diastolic function, myocardial injury and to outcome.MethodsIn a prospective, observational, cohort study we enrolled 50 patients with SIRS and shock despite fluid resuscitation. Transthoracic echocardiography (TTE) measuring LV function was performed within 12 hours after admission and daily for a 7-day observation period. TTE and laboratory measurements were related to 28-day mortality.ResultsMAPSE on day 1 correlated significantly with LV ejection fraction (LVEF), tissue Doppler indices of LV diastolic function (é, E/é) and high-sensitive troponin T (hsTNT) (p< 0.001, p= 0.039, p= 0.009, p= 0.003 respectively) whereas LVEF did not correlate significantly with any marker of LV diastolic function or myocardial injury. Compared to survivors, non-survivors had a significantly lower MAPSE (8 [IQR 7.5-11] versus 11 [IQR 8.9-13] mm; p= 0.028). Other univariate predictors were age (p=0.033), hsTNT (p=0.014) and Sequential Organ Failure Assessment (SOFA) scores (p=0.007). By multivariate analysis MAPSE (OR 0.6 (95% CI 0.5- 0.9), p= 0.015) and SOFA score (OR 1.6 (95% CI 1.1- 2.3), p= 0.018) were identified as independent predictors of mortality. Daily measurements showed that MAPSE, as sole echocardiographic marker, was significantly lower in most days in non-survivors (p<0.05 at day 1–2, 4–6).ConclusionsMAPSE seemed to reflect LV systolic and diastolic function as well as myocardial injury in critically ill patients with shock. The combination of MAPSE and SOFA added to the predictive value for 28-day mortality.

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Concordance between M-mode, pulsed Tissue Doppler, and colour Tissue Doppler in the assessment of mitral annulus systolic excursion in normal subjects

Abstract: Despite strict correlations exist between M-mode and TD in the assessment of mitral annulus systolic excursion, the effective concordance between techniques is sub-optimal.

Cited by 27 publications

References 21 publications

Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care

Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Mitral annular plane systolic excursion (MAPSE) in shock: a valuable echocardiographic parameter in intensive care patients

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