The relation between ejection fraction and mitral annulus motion before and after direct‐current electrical cardioversion

Abstract

Mitral annulus motion (MAM) and the relation between left ventricular ejection fraction (EF) and MAM has been shown to differ between patients with sinus rhythm and patients with atrial fibrillation. However, it has not been investigated how the relation between EF and MAM changes on direct-current (DC) electrical cardioversion to sinus rhythm. Therefore, 31 consecutive patients on the waiting list for DC electrical cardioversion were examined by echocardiography before DC electrical cardioversion, and those who maintained sinus rhythm (13 patients) were examined again 4-8 weeks after cardioversion. The conversion factor (CF) (ratio EF/MAM) decreased from 8.4 +/- 1.7 before to 5.8 +/- 0.8 SD after cardioversion (P<0.001). The EF increased slightly (P<0.05) but the MAM had a much greater increase (P<0.001), resulting in the decrease in CF. There was no significant difference in CF between patients after cardioversion and age- and gender-matched control patients with sinus rhythm, indicating that CF is normalized or almost normalized 4-8 weeks after cardioversion. This indicates that when MAM is used for investigation of the left ventricular function, and the function is expressed as EF, the same CF as in other patients with sinus rhythm can be used 4-8 weeks after DC electrical cardioversion.

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

“…In critical care settings where acoustic windows are often suboptimal, MAPSE seems to be an attractive parameter. A decreased MAPSE is known to be associated with conditions affecting LV function such as myocardial infarction, heart failure, atrial fibrillation and age [15-17] and its relation to mortality has been described by several studies in patients with cardiovascular disease [15,19-21]. …”

“…Although MAPSE and LVEF may be related, they are not entirely interchangeable [13,17]. MAPSE is suggested to be primarily representative of subendocardial, longitudinally oriented, myocardial fibres compared to the subepicardial, circumferential fibres measured by LVEF, and is known to detect more subtle abnormalities of LV function [7,18].…”

“…It has been suggested as a surrogate measurement for LVEF in cardiac patients [12,14]. A reduced MAPSE has been shown to correlate with age, and LV function in patients with myocardial infarction, heart failure and atrial fibrillation [15-17] and to be more sensitive than conventional echocardiographic markers in detecting abnormalities in LV systolic function at an early stage [7,18]. MAPSE is known to be prognostic for major cardiac events and mortality in patients with cardiovascular disease [15,19-21].…”

Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applications

“…AVPD has been shown to be independently associated with the inverse logarithm of early transmitral flow deceleration time in patients with heart failure (HF) [11], and with the severity of LV diastolic impairment in patients with coronary artery disease (CAD) [12]. Notably, left atrial contraction has been proposed to affect AVPD via FrankStarling mechanisms [13], a finding that may explain the presence of reduced AVPD in patients with atrial fibrillation (AF) as compared to age-matched controls in sinus rhythm [14]. Second, AVPD does not correspond to the effective annular excursion occurring during systole.…”

Visually estimated left ventricular ejection fraction by echocardiography is closely correlated with formal quantitative methods

“…The patients were included either within a week after an acute myocardial infarction (n=54) or within two weeks before a planned coronary angiography in patients with stable angina (n=35). Since atrial fibrillation has been shown to decrease AV plane displacement disproportionately to left ventricular ejection fraction [12,13], only patients in sinus rhythm were included in the present study.…”