27. New echocardiogram index alternatives to MAPSE and TAPSE z-scores in children

Abstract

Background Mitral annular plane systolic excursion (MAPSE), and tricuspid annular plane systolic excursion (TAPSE) are relatively load independent longitudinal left ventricle (LV) and right ventricle (RV) measurement in both adults and children. Normal paediatric values of MAPSE and TAPSE unlike adults are based on inconvenient z-scores. We hypothesize novel indexes of (LSI) LV longitudinal systolic index and (RSI) RV longitudinal systolic index are BSA, age, gender independent and nullifies the need for MAPSE and TAPSE z-scores. Methods Normal echocardiograms were retrospectively reviewed from 2009 to 2011. Ejection fraction, LV dimensions, MAPSE, and TAPSE were determined. LSI and RSI were calculated using MAPSE and TAPSE divided by LV length. Echocardiogram indices were correlated. Regression analysis was done for BSA, age, and gender. Results Two hundred and one patients had normal ejection fractions (67.3;±5.1%). Mean MAPSE 10.4;±3.3mm, z-score −0.07;±1.2, and LSI 0.20;±0.03; Mean TAPSE 17.4;±5.4mm, z-score 0.74;±1.7, and RSI 0.34;±0.06. LSI and MAPSE z-scores correlated, r =0.73, p r =0.76, p p value Conclusion LSI obviates need for-MAPSE z scores. RSI offers an additional non TAPSE z-score method to evaluate RV function, but does not nullify age effect. RSI, especially in the first two months is decreased.