Journal of the American Society of Echocardiography
Clinical InvestigationLeft Ventricular FunctionMitral Annular Plane Systolic Excursion as a Surrogate for Left Ventricular Ejection Fraction
Section snippets
Methods
The study design was a retrospective analysis of echocardiograms obtained for clinical indications. Six hundred consecutive two-dimensional (2D) echocardiographic studies done in the echocardiography laboratory at Lenox Hill Hospital (an urban teaching hospital) were included in our study (Philips iE33 xMATRIX Ultrasound System; Philips Medical Systems, Andover, MA). M-mode echocardiography through the mitral valve annulus, from the apical four-chamber view at both the septal and lateral
Calibration Cohort
Three hundred consecutive 2D echocardiographic studies were reviewed by the medical student, and MAPSE values were measured in all 300 patients. No patients were excluded from data analysis. Data recorded for each patient are listed in Table 1. Of all the patient characteristics documented, gender had the greatest correlation with EF. Although MAPSE values were similar between genders, we found that on average, a given MAPSE value correlated with a higher EF in women. Given this observation,
Discussion
Our results demonstrate that MAPSE values, measured by an untrained reader, are accurate predictors of left ventricular EF. We verified this in a large cohort of consecutive patients (600) with no exclusion criteria, representative of what might be seen in any busy echocardiography laboratory. This is the largest study thus far to correlate MAPSE and EF.
We created a simple algorithm for the prediction of EF on the basis of MAPSE values; high and low cutoff values were defined to help quickly
Conclusions
Our work has determined that MAPSE, measured by an untrained observer, is a viable surrogate for expert determined left ventricular EF. Our findings suggest that gender significantly affects this correlation. We have established upper and lower thresholds for normal and severely reduced EFs for each gender and a simple gender-specific equation to calculate EF from intermediate MAPSE values. We believe that MAPSE should be routinely acquired in all echocardiographic studies and used as a
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