Mitral Annular Plane Systolic Excursion-Derived Ejection Fraction: A Simple and Valid Tool in Adult Males With Left Ventricular Systolic Dysfunction.

Abstract

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. 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. 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. 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). 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.