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Tissue motion annular displacement of the mitral valve using two-dimensional speckle tracking echocardiography predicts the left ventricular ejection fraction in normal children

Published online by Cambridge University Press:  27 June 2013

David E Black ,
Jen Bryant ,
Charles Peebles ,
Keith M Godfrey ,
Mark Hanson  and
Joseph J Vettukattil
David E Black*
Affiliation:
Institute of Developmental Sciences, Human Development and Health Academic Unit, University of Southampton, Southampton, United Kingdom Pediatric Cardiology and Cardiothoracic Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Jen Bryant
Affiliation:
Institute of Developmental Sciences, Human Development and Health Academic Unit, University of Southampton, Southampton, United Kingdom MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Charles Peebles
Affiliation:
Pediatric Cardiology and Cardiothoracic Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Keith M Godfrey
Affiliation:
Institute of Developmental Sciences, Human Development and Health Academic Unit, University of Southampton, Southampton, United Kingdom MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Mark Hanson
Affiliation:
Institute of Developmental Sciences, Human Development and Health Academic Unit, University of Southampton, Southampton, United Kingdom MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Joseph J Vettukattil
Affiliation:
Pediatric Cardiology and Cardiothoracic Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
*
Correspondence to: Dr D. E. Black, MBBCh, MRCPCH, FCP, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO166YD, United Kingdom. Tel: 07548322088; Fax: 02380798419; E-mail: david.black@uhs.nhs.uk
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Abstract

Background: The gold standard for determining the left ventricular ejection fraction is cardiac magnetic resonance imaging. Other parameters for determining the ejection fraction such as M-mode echocardiography are operator-dependant and often inaccurate. Assessment of the displacement of the mitral valve annulus using two-dimensional speckle tracking echocardiography may provide an accurate and simple method of determining the left ventricular ejection fraction in children. Method: We retrospectively studied 70 healthy 9-year-old children with no history of cardiovascular disease who had been assessed using cardiac magnetic resonance imaging and two-dimensional transthoracic echocardiography. Mitral displacement was determined using the tissue motion annular displacement (TMAD) feature of Philips QLAB version 9. The midpoint displacement of the mitral valve was calculated, and the predicted left ventricular ejection fraction was compared with magnetic resonance imaging-derived and M-mode-derived ejection fractions. Results: The mean ejection fraction derived from magnetic resonance imaging (64.5 (4.6)) was similar to that derived from the TMAD midpoint (60.9 (2.7), p = 0.001) and the M-mode (61.9 (7), p = 0.012). The TMAD midpoint correlated strongly with the magnetic resonance imaging-derived ejection fraction (r = 0.69, p < 0.001), as did the predicted fraction (r = 0.67, p < 0.001). The M-mode ejection fraction showed a poor linear correlation with both magnetic resonance imaging-derived and TMAD-derived fractions (r = 0.33 and 0.04, respectively). Conclusion: TMAD of the mitral valve is a simple, effective, and highly reproducible method of assessing the ejection fraction in normal children. It shows a strong linear correlation with magnetic resonance imaging-derived ejection fraction and is superior to M-mode-derived ejection fractions.

Keywords

Speckle trackingmitral displacementfunction
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 640 - 648
Copyright
Copyright © Cambridge University Press 2013 

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