The relation between mitral annulus motion and ejection fraction changes with age and heart size

Emilsson, Kent; Wandt, Birger

doi:10.1046/j.1365-2281.2000.00221.x

Cited by 31 publications

(25 citation statements)

References 23 publications

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“…AVPD and TDI may be superior in detecting subtle abnormalities of LV systolic function [43] and in patients with subclinical heart disease [44,45], as well as with increasing age [46]; longitudinal contractility is reduced whereas LVEF is preserved. A number of possible mechanisms exist by which subendocardial, longitudinal LV function may become impaired earlier than subepicardial, circumferential LV function [47].…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

et al. 2011

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“…MAPSE represents a direct measure of the ratio of longitudinal left ventricular wall contractility during systole and diastole, whereas LVEF represents the indirect ratio of LV volumes being assessed by circumferential planimetrics of the LV cavity. Therefore, MAPSE might reveal more subtle and direct contractility dysfunctions compared to LVEF [33]. It was shown that patients with a preserved ejection fraction (those with increasing age, hypertension, myocardial hypertrophy, or diastolic dysfunction) reveal an impaired long-axis contractile function earlier, even when radial function still remains preserved [34].…”

Section: Discussionmentioning

confidence: 99%

Galectin-3 Reflects Mitral Annular Plane Systolic Excursion Being Assessed by Cardiovascular Magnetic Resonance Imaging

et al. 2016

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Background. This study investigates whether serum levels of galectin-3 may reflect impaired mitral annular plane systolic excursion (MAPSE) in patients undergoing cardiac magnetic resonance imaging (cMRI). Methods. Patients undergoing cMRI during routine clinical care were included prospectively within an all-comers design. Blood samples for biomarker measurements were collected within 24 hours following cMRI. Statistical analyses were performed in all patients and in three subgroups according to MAPSE (MAPSE I: ≥11 mm, MAPSE II: ≥8 mm–<11 mm, and MAPSE III: <8 mm). Patients with right ventricular dysfunction (<50%) were excluded. Results. 84 patients were included in the study. Median LVEF was 59% (IQR 51–64%). Galectin-3 correlated significantly with NT-proBNP (r = 0.42, p = 0.0001). Galectin-3 increased significantly according to the different stages of impaired MAPSE (p = 0.006) and was able to discriminate both patients with impaired MAPSE <11 mm (area under the curve (AUC) = 0.645, p = 0.024) and <8 mm (AUC = 0.733, p = 0.003). Combining galectin-3 with NT-proBNP improved discrimination of MAPSE <8 mm (AUC 0.803, p = 0.0001). In multivariable logistic regression models galectin-3 was still associated with impaired MAPSE (MAPSE < 11 mm: odds ratio (OR) = 3.53, p = 0.018; MAPSE < 8 mm: OR = 3.18, p = 0.06). Conclusions. Galectin-3 reflects MAPSE being assessed by cardiac MRI.

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“…M-mode images were obtained at the LV septal, lateral, anterior, and posterior borders of the mitral ring in the apical 2C- and 4C views, and an average mitral annular plane systolic excursion (MAPSE) value was calculated [18]. …”

Section: Methodsmentioning

confidence: 99%

Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

Lončarević¹,

Trifunović

Soldatović

et al. 2016

BMC Cardiovasc Disord

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BackgroundWhether type 2 diabetes mellitus (DM) in the absence of hypertension (HTA) and coronary artery disease (CAD) affects left ventricular (LV) phenotype and function among asymptomatic DM patients that can be easily discovered in everyday practice, what is the clinical risk profile for diabetic cardiomyopathy and how HTA and CAD modulate LV structure and function above diabetic cardiomyopathy, are still incompletely answered questions.MethodsIn 210 DM patients (group I: 70 asymptomatic DM patients without HTA and CAD; group II: 70 DM patients with HTA and no CAD; group III: 70 DM patients with CAD and no HTA) and 80 healthy individuals, comprehensive echocardiography including speckle tracking strain and strain rate analysis, was done.ResultsCompared to control DM patients without HTA and CAD had increased LV mass, more frequently concentric remodeling, impaired LV relaxation and lower LV ejection fraction (EF), fraction of shortening (FS) and mitral annular plane excursion (MAPSE). Addition of HTA further impaired EF, FS and MAPSE and aggravated diastolic dysfunction, whereas concomitant CAD further impaired FS and MAPSE. Peak global longitudinal strain (Slong) and early diastolic longitudinal strain rate (SRlong E) were impaired in group I compared to control, even when EF was preserved. Peak circumferential strain (Scirc) was impaired only when DM was associated with HTA or CAD. In multivariate analysis DM was significantly and independently from HTA, CAD, age, gender and body mass index associated with: increased LV mass, concentric LV remodeling, lower EF, FS, MAPSE, Slong, SRlongE and distorted diastolic parameters. DM duration, glycosylated hemoglobin, microalbuminuria and retinopathy, were not independent predictors of LV geometry and function.ConclusionDM per se has strong and independent influence on LV phenotype and function that can be detected by conventional and speckle tracking echocardiography in everyday clinical practice, even in asymptomatic patients. We could not confirm that these changes were independently related to duration of DM, quality of metabolic control and presence of microvascular complications. Concomitant HTA or CAD furthermore distorted LV systolic and diastolic function.

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The relation between mitral annulus motion and ejection fraction changes with age and heart size

Cited by 31 publications

References 23 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

Galectin-3 Reflects Mitral Annular Plane Systolic Excursion Being Assessed by Cardiovascular Magnetic Resonance Imaging

Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

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