Correlation of Mitral Annular Plane Systolic Excursion (MAPSE) and Tissue Doppler peak Systolic Velocity with Left Ventricular Systolic Function

Abstract

Background: Estimation of left ventricular function has major diagnostic and prognostic importance in cardiac patients. The most commonly used measure of the systolic function of the left ventricle is ejection fraction (EF), however, the accuracy is limited especially in patients with poor image quality. Mitral annular plane systolic excursion (MAPSE) and tissue Doppler peak systolic velocity (TD PSV) are measurements of longitudinal function which has been shown to correlate with LV global systolic function. Objective:To validate the correlation of mitral annular plane systolic excursion (MAPSE) and TD PSV (Sm) at the medial and lateral mitral annuli as surrogates for estimation of LV systolic function. Methods:The study included 200 patients divided into 2 groups; Group (A) which included 100 patients with normal EF as assessed by biplane Simpson's method (defined as EF>50%) and Group (B) which included 100 patients with reduced ejection fraction (defined as EF<50%). MAPSE and TD PSV (Sm) were recorded at medial and lateral mitral annuli in the apical four-chamber approach. Results:The cut off value of MAPSE at medial annulus of ≤ 7mm suggested an impaired systolic function with sensitivity of 73 % and specificity of 100%. While the cut off value of MAPSE at lateral annulus of ≤ 10mm suggested an impaired systolic functions with sensitivity of 82% and specificity of 93%. TD PSV (Sm) cut off value at the Medial and lateral annuli ≤ 7cm/s suggested an impaired LV systolic function with sensitivity of 91% and specificity of 85% for the medial annulus and with sensitivity of 72% and specificity of 93% for the lateral annulus. When the cut-off values of both parameters (TD PSV and MAPSE) were combined to detect LVEF<50, the sensitivity and specificity increased to 95.9% and 100 % respectively for the Medial Mitral annulus and 85.5% and 97.7% respectively for the lateral Mitral annulus Conclusion: Combining the measurement of both MAPSE and Mitral annular TD PSV increased their sensitivity and specificity for predicting normal or subnormal EF.

Correlation between tissue Doppler-derived left ventricular systolic velocity (S’) and left ventricle ejection fraction in sepsis and septic shock: a retrospective cohort study

“…Mitral S’ is routinely performed as a part of systolic assessment of the LV, while MAPSE is still not part of comprehensive TTE. The correlation between mitral S’ and LVEF is good-to-excellent among stable cardiac outpatients [ 6 , 11 – 13 , 31 ]. However, studies in critically ill patients remains limited in sample size, and evidence so far suggests that mitral S’ values are not associated with prognosis in septic patients [ 14 , 15 ], which was confirmed by a recent meta-analysis [ 32 ].…”

“…Numerous studies have explored the association between mitral S’ and LVEF and found a good-to-excellent correlation these two variables in non-critically ill patients [ 6 , 11 – 13 ]. On the other hand, previous studies in critically ill patients have found varied results between these two echocardiographic variables [ 14 , 15 ].…”

Correlation between Tissue Doppler-derived left ventricular systolic velocity (mitral S’) and left ventricle ejection fraction (LVEF) in sepsis and septic shock: A retrospective cohort study

“…Mitral s' is routinely available as a part of diastolic assessment of the LV, while MAPSE is still not part of comprehensive TTE. In non-critically ill patients, the correlation between mitral s' and LVEF is good to excellent among stable cardiac outpatients [6, [11][12][13]31]. However, studies in critically ill patients remains limited in sample size, and mitral s' values are not associated with prognosis in septic patients [14,15,32].…”

“…Numerous studies have explored the association between mitral S' and LVEF and found a good to excellent correlation these two variables in non-critically ill patients [6, [11][12][13]. On the other hand, previous studies in critically ill patients have found varied results between these two echocardiographic variables [14,15].…”