Abstract

BackgroundThe aim of the study was to investigate the relationship between the ejection fraction (EF) and the mitral annular systolic velocity (Sm) in patients with preserved left ventricular systolic function (EF>55%). The study task was to evaluate whether the assessment of Sm(avg) can be used as an alternative to the Simpson’s method in assessment of the EF. The expected benefit was that Sm could be used to predict EF, when EF is difficult to assess due to poor image quality (IQ).MethodSm was obtained by spectral pulse wave Tissue Doppler Imaging (pwTDI) from the lateral and septal sites of the mitral annulus (MA) and an averaged value was calculated - Sm(avg). EF was assessed using Simpson’s rule. Participants were divided into controls (n=70), hypertensive (HTN, n=56), HTN with diastolic dysfunction (HTN/DD, n=65), HTN with diabetes mellitus (HTN/DM, n=52) and HTN with DD and DM (HTN/DD/DM, n=65).ResultsSm(avg) showed strong correlation with EF (r=0.978; p<0.0001). There were no significant differences between the correlation coefficients between the subgroups and the controls. The mathematical model that the study recommended to assess the EF is: EF=45.0 + 2 × Sm(avg).ConclusionThe assessment of Sm(avg) could be used as an alternative to EF. This approach may be useful especially when the IQ is poor. The method maintains high accuracy and reproducibility in prediction of the EF.

Highlights

  • The aim of the study was to investigate the relationship between the ejection fraction (EF) and the mitral annular systolic velocity (Sm) in patients with preserved left ventricular systolic function (EF>55%)

  • There were no significant differences between the correlation coefficients between the subgroups and the controls

  • There were no patients with signs and symptoms of coronary heart disease (CHD), or more than a mild valvular heart disease (Table 1)

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Summary

Introduction

The aim of the study was to investigate the relationship between the ejection fraction (EF) and the mitral annular systolic velocity (Sm) in patients with preserved left ventricular systolic function (EF>55%). The study task was to evaluate whether the assessment of Sm(avg) can be used as an alternative to the Simpson’s method in assessment of the EF. Left ventricular (LV) longitudinal shortening during ejection reflects mitral annulus (MA) descent and has been used as an index of the global systolic function [1,2,3,4,5]. Previous studies using routine M mode, twodimensional echocardiography and colour-coded M mode TDI measures of MA systolic excursions have shown close correlation with EF which is an accepted standard reference of LV systolic function [6,7,8]. Many factors influence the EF/Sm(avg) ratio, such as gender, age, presence and grade of hypertension (HTN), diastolic dysfunction (DD), coronary heart disease (CHD), diabetes mellitus (DM) etc [11,12]

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