Value of mitral annular plane systolic excursion in the assessment of contractile reserve in patients with ischemic cardiomyopathy before cardiac revascularization

Autor: Maher Ragab, Ebtihag Hamdy, Tarek Elzawawy, Gehan Magdy
Rok vydání: 2018
Předmět:
Male
BP
blood pressure

Mitral annulus systolic excursion
Wall motion score index
Dobutamine stress echocardiography
CAD
coronary artery disease

medicine.medical_treatment
Myocardial Ischemia
030204 cardiovascular system & hematology
Coronary Angiography
Ventricular Function
Left

030218 nuclear medicine & medical imaging
0302 clinical medicine
Valvular disease
Ea
early diastolic annular velocity

Myocardial Revascularization
TDI
tissue Doppler imaging

Sa
systolic annular velocity

Ejection fraction
HR
heart rate

E
early transmitral inflow velocity

Middle Aged
Coronary Vessels
Aa
late diastolic annular velocity

LVEDV
left ventricular end diastolic volume

Preoperative Period
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
E/Ea
the ratio of early transmitral velocity to early diastolic mitral annular velocity

Blood Flow Velocity
Echocardiography
Stress

LVESV
left ventricular end systolic volume

medicine.medical_specialty
RD1-811
Systole
Revascularization
MAPSE
mitral annular plane systolic excursion

03 medical and health sciences
Internal medicine
medicine
Diseases of the circulatory (Cardiovascular) system
Humans
EF
ejection fraction

In patient
Cardiac Imaging
Longitudinal function
Ischemic cardiomyopathy
A
late transmitral inflow velocity

Retrospective Studies
Echocardiography
Doppler
Pulsed

WMSI
wall motion score index

business.industry
Stroke Volume
Contractile reserve
ACEI
angiotensin converting enzyme inhibitors

Myocardial Contraction
LV
left ventricle

RC666-701
Surgery
ECG
electrocardiogram

DSE
dobutamine stress echocardiography

business
Follow-Up Studies
Zdroj: Indian Heart Journal
Indian Heart Journal, Vol 70, Iss 3, Pp 373-378 (2018)
ISSN: 0019-4832
DOI: 10.1016/j.ihj.2017.11.004
Popis: Background: Mitral annular plane systolic excursion (MAPSE) is an M-mode derived echocardiographic marker of left ventricular longitudinal function, the aim of this study is to evaluate the value of MAPSE in assessment of contractile reserve in patients with ischemic cardiomyopathy before cardiac revascularization. Methods: The study included 50 patients with ischemic cardiomyopathy with ejection fraction (EF) ≤35%, the patients presented to echocardiography laboratory for dobutamine stress echocardiography (DSE) to assess viability and contractile reserve before revascularization, patients with primary valvular disease, and those with significant mitral annular calcifications were excluded from the study. A low dose DSE was done to all patients using standardized incremental infusions of 5, 10, and 20 μg/kg/min and the following parameters were measured at both baseline and peak dose, (EF, wall motion score index(WMSI) and MAPSE). Contractile reserve was measured as the difference between the low dose and baseline values of the EF and WMSI. Results: The study included 50 patients aged 55.08 ± 7.15 years, 94% were males, the DSE protocol was complete in all patients without serious side effects. A total of eight hundred segments were analyzed, at baseline 65% were dysfunctional including 31.2% hypokinetic, 28.8% were akinetic, and 5% were dyskinetic. At low dose study 70% of the dysfunctional myocardium showed viability, EF increased significantly from 30.84 ± 4.56 to 42.24 ± 8.15%, p 10% (AUC = 0.6, sensitivity 67.86, specificity 59.09), and Δ MAPSE ≥1.8 mm can predict contractile reserve at ΔWMSI ≤0.20 (AUC = 0.61, sensitivity 65.5, specificity 75.6). Conclusions: MAPSE is a rapid simple quantitative echocardiographic method that can asses contractile reserve in patients with ischemic cardiomyopathy before cardiac revascularization. Keywords: Mitral annulus systolic excursion, Contractile reserve, Ischemic cardiomyopathy
Databáze: OpenAIRE