Mitral Annular Plane Systolic Excursion: An Early Marker of Mortality in Severe COVID-19

Jarori, Upasana; Maatman, Thomas K.; Maatman, Benjamin; Mastouri, Ronald; Sawada, Stephen; Khemka, Abhishek

doi:10.1016/j.echo.2020.08.012

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…18 In a study evaluating patients in the ICU for severe COVID-19, MAPSE emerged as the only left heart parameter independently associated with increased mortality. 19 The results are similar in studies conducted in patients with septic shock. While no difference was found in LVEF in adult patients with septic shock, a decrease in MAPSE was shown as an indicator of myocardial depression compared to non-septic patients.…”

Section: Resultssupporting

confidence: 79%

“…In a 10‐year follow‐up study, MAPSE was shown to be a strong risk predictor for long‐term survival 18 . In a study evaluating patients in the ICU for severe COVID‐19, MAPSE emerged as the only left heart parameter independently associated with increased mortality 19 . The results are similar in studies conducted in patients with septic shock.…”

Section: Discussionmentioning

confidence: 63%

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The relation of echo‐derived lateral MAPSE to left heart functions and biochemical markers in patients with preserved ejection fraction: Short‐term prognostic implications

Özer

Gövdeli

Demirtakan

et al. 2022

J of Clinical Ultrasound

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Objective Mitral annular plane systolic excursion (MAPSE) is a simple way to evaluate—left ventricle (LV) function. Our aim was to explain the relationship of MAPSE with LV function and biochemical markers in patients with preserved ejection fraction (EF), and to determine whether it has an effect on prognosis in echocardiography (echo) practice. Methods Consecutive patients referred to the echo laboratory between November 2020 and March 2021 were included in the study. In addition to conventional parameters, MAPSE of the lateral mitral annulus was measured in all patients. Patients were divided into three groups according to lateral MAPSE: low (<12 mm), relatively preserved (12–15 mm), and high (≥15 mm). Results A total of 512 patients with preserved EF were included in the study. MAPSE was low in 44 patients (9%), relatively preserved in 231 patients (45%), and high in 237 patients (46%). The mean age was higher in the low group compared to the other two groups (p < 0.001) and the body mass index was increased in the low group compared to the high group (p = 0.010). Atrial fibrillation and hypertension were more common in patients with low MAPSE. The rate of diastolic dysfunction (DD) and all‐cause hospitalization were higher in the low and relatively preserved groups than in the high group (p < 0.001, p = 0.002; respectively). The pro‐BNP level and mortality rate were higher in the low group compared to the relatively preserved and high groups (p = 0.007, p = 0.005; respectively). MAPSE was identified as independent predictor of hospitalization (OR: 0.284, 95% CI: 0.093–0.862, p = 0.026) via multivariate analysis and independent predictor of in‐hospital mortality (HR: 0.002, 95% CI: 0–0.207, p = 0.008). Conclusions Analysis of LV longitudinal function by echo‐derived lateral MAPSE when LV ejection fraction is normal provides important information about DD and related heart failure and may predict prognosis in echo practice.

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Section: Resultssupporting

confidence: 79%

Section: Discussionmentioning

confidence: 63%

The relation of echo‐derived lateral MAPSE to left heart functions and biochemical markers in patients with preserved ejection fraction: Short‐term prognostic implications

Özer

Gövdeli

Demirtakan

et al. 2022

J of Clinical Ultrasound

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“…Also in other investigation comprising 110 patients, 21.8% of the patients presented myocardial injury, and 54% from those patients LV dysfunction was demonstrated [ 32 ].. In other retrospective study comprising 68 patients, mortality was related to MAPSE [ 33 ]. For the analysis of the right ventricle, we found normal mean values for the parameters of TAPSE, FAC, and free wall longitudinal strain (although 2.7% of the patients presented abnormal values), but not for the analysis of the global longitudinal strain (mean: − 15.69 ± 3.90%), and 17.1% of the patients presented with right ventricular dilatation or abnormal function (considering one abnormal parameter).…”

Section: Discussionmentioning

confidence: 96%

In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience

Vieira

Afonso

Oliveira

et al. 2021

Cardiovasc Ultrasound

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Background Information is lacking concerning in-hospital echocardiography analysis of COVID-19 infection in Brazil. We evaluated echocardiographic parameters to predict a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure. Methods A prospective full echocardiographic study of consecutive patients hospitalized with COVID-19, single tertiary centre in Brazil. We correlated echocardiographic findings to biomarkers, clinical information, thoracic tomography, and in-hospital composite endpoint of mortality, pulmonary thromboembolism or renal failure. Results One hundred eleven patients from March to October 2020, 67 ± 17 years, 65 (58.5%) men, death was observed in 21/111 (18.9%) patients, 48 (43%) required mechanical ventilation, myocardial infarction occurred in 10 (9%), pulmonary thromboembolism in 7 (6.3%) patients, haemodialysis was required for 9 (9.8%). Echocardiography was normal in 51 (46%) patients, 20 (18%) presented with decreased left ventricle ejection, 18 (16.2%) had abnormal left ventricle global longitudinal strain, 35 (31%) had diastolic dysfunction, 6 (5.4%) had an E/e’ratio > 14, 19 (17.1%) presented with right ventricle dilated/dysfunction, 31 (28%) had pericardial effusion. The echocardiographic parameters did not correlate with mortality, biomarkers, clinical events. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure (p: 00.3; value: 2.65 m/s; AUC ROC curve: 0.739; sensitivity: 73.3; specificity: 66.7; CI: 0.95, inferior: 0.613; superior: 0,866). Conclusions Among hospitalized patients with COVID-19, echocardiography was normal in 51(46%) patients, and 20 (18%) patients presented with a decreased left ventricle ejection fraction. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.

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“…MAPSE, which is used to evaluate longitudinal LV systolic function, is an early indicator of myocardial disease. In a study conducted with patients hospitalized with a diagnosis of COVID-19, although there was no difference in LVEF and LV diastolic dysfunction (E/a') between those that died and those that survived, it was reported that MAPSE was lower in the former, and it was an independent predictor of mortality 6 . In a study including patients who had been hospitalized with a diagnosis of mild to moderate COVID-19 pneumonia and discharged, who had no known history of cardiovascular disease, echocardiography was performed in the postacute COVID phase (<12 weeks), and LV dysfunction was detected in 8.8% of patients and diastolic dysfunction in 16.8% 19 .…”

Section: Discussionmentioning

confidence: 96%

“…Mitral annular plane systolic excursion (MAPSE) is a linear echocardiographic measurement that assesses longitudinal LV function. MAPSE has been shown to predict mortality in critically ill COVID-19 patients 6 . Tricuspid annular plane systolic excursion (TAPSE) is a specific and easily quantifiable parameter that shows global RV function and describes apical to basal shortening 7 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the right and left ventricular functions of patients that recovered from COVID‑19 at home

et al. 2021

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Objective: Coronavirus disease 2019 ) is an infection that can involve various systems and organs, as well as the cardiovascular system. There are several reports in the literature on cardiac involvement in COVID-19 patients who are hospitalized. Therefore, the current research was designed to determine whether cardiac involvement occurred in COVID-19 patients at home. Methods:The current research included 30 patients with a positive COVID-19 PCR test but no hospitalization and recovery at home, and also 30 healthy volunteers. All participants underwent routine and transthoracic echocardiographic exams. The left and right ventricular diameters and functions were examined using two-dimensional echocardiography. M-mode imaging was used to assess tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE). In addition, the tissue Doppler images of the patients were recorded.Results: In the COVID-19 group, 53% of the patients were male, and the mean age was 35.6 years (±7.6). The control group consisted of 57% males, and the mean age was 35.1 years (±6.9). The right and left ventricular diameters, systolic pulmonary artery pressure, and TAPSE and MAPSE values were similar in the two groups. In both groups, the tricuspid lateral annular systolic velocity (S' tricuspid) values were in the normal reference range. However, the S' tricuspid value was statistically lower in the COVID-19 group than in the control group (13 [14-11] vs. 14 [15-13]; p=0.010). Conclusion:In this study, cardiac functions did not significantly differ between patients with mild COVID-19 infection and the control group.

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Mitral Annular Plane Systolic Excursion: An Early Marker of Mortality in Severe COVID-19

Cited by 4 publications

References 7 publications

The relation of echo‐derived lateral MAPSE to left heart functions and biochemical markers in patients with preserved ejection fraction: Short‐term prognostic implications

The relation of echo‐derived lateral MAPSE to left heart functions and biochemical markers in patients with preserved ejection fraction: Short‐term prognostic implications

In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience

Evaluation of the right and left ventricular functions of patients that recovered from COVID‑19 at home

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