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 |
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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 |
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