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Mitral Annular Plane Systolic Excursion–Derived Ejection Fraction: A Simple and Valid Tool in Adult Males With Left Ventricular Systolic Dysfunction
Author(s) -
Adel Walaa,
Roushdy Alaa M.,
Nabil Mohamed
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13009
Subject(s) - ejection fraction , cardiology , medicine , excursion , cutoff , ventricular function , heart failure , physics , quantum mechanics , political science , law
Objectives Validation of a mitral annular plane systolic excursion ( MAPSE )–derived formula to calculate the ejection fraction where EF = 4.8 × MAPSE (mm) + 5.8 in adult males with left ventricular ( LV ) dysfunction. Background Echocardiographic assessment of LV function generally requires expert echocardiographer and is somewhat subjective and prone to reader discordance. MAPSE has been suggested as a surrogate measurement for LV function. Methods Prospective analysis of 170 male patients with systolic dysfunction by two‐dimensional transthoracic echocardiography was carried out. MAPSE and ejection fraction measured by qualitative visual inspection, M‐mode, and biplane modified Simpson's rule were measured. MAPSE ‐derived EF was compared against other conventional methods to measure EF using Bland–Altman analysis and independent t ‐test. Results There was a significant positive correlation between average MAPSE and EF measured by M‐mode (r = 0.554, P < 0.001), Simpson's rule (r = 0.585, P < 0.001), and visual inspection (r = 0.611, P < 0.001). An average MAPSE cutoff value <= 5 provided the best balanced sensitivity (67.1%) and specificity (76.5%) to predict EF < 30%. The mean difference between MAPSE ‐derived EF and EF measured by visual inspection and by Simpson's method was 3.86 ± 5.24% and 3.57 ± 5.97%, respectively. The least mean difference of 0.5 ± 5.69% was present between MAPSE ‐derived EF and M–mode‐measured EF (P value 0.2). Conclusion MAPSE ‐derived EF using the equation EF = 4.8 × MAPSE (mm) + 5.8 is a valid technique in adult males with severely impaired LV EF .