Simplifying Left Ventricular Function Assessment: The Clinical Value of Mitral Annular Plane Systolic Excursion

简化左心室功能评估:二尖瓣环平面收缩期位移的临床价值

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Abstract

BACKGROUND: Left ventricular (LV) dysfunction is a critical global health concern, usually assessed using parameters such as global longitudinal strain (GLS) and LV ejection fraction (LVEF) by Simpson's method. However, these methods can be resource-intensive and reliant on high-quality imaging. Mitral annular plane systolic excursion (MAPSE) offers a simpler, more accessible bedside alternative for evaluating LV function. OBJECTIVE: This study explored how MAPSE correlates with key echocardiographic parameters, such as GLS and LVEF, to establish its role as a practical and reliable tool for assessing LV systolic longitudinal function. METHODS: We conducted a single-center cross-sectional study with 80 patients diagnosed with LV dysfunction (LVEF <50%). Echocardiographic assessments measured were MAPSE, GLS, and LVEF. Statistical analyses examined the relationships between these parameters. RESULTS: MAPSE showed a strong correlation with GLS (r = 0.535, P < 0.0001) and a moderate correlation with LVEF (r = 0.324, P < 0.0001). Patients with more severe LV dysfunction (ejection fraction [EF] <40%) had lower mean MAPSE values (11.1 ± 0.4 mm) than those with milder dysfunction (EF >40%, MAPSE 12.4 ± 0.4 mm). MAPSE also correlated inversely with LV filling pressures (E/e' >14, P < 0.0001) and LV end-systolic dimensions (r = -0.254, P = 0.022). Interestingly, its positive association with tricuspid annular plane systolic excursion (P = 0.0046) highlighted its role in possibly reflecting biventricular function and ventricular interdependence. CONCLUSION: MAPSE is a simple yet powerful tool for assessing LV function, offering strong correlations with GLS and insights into systolic and diastolic performance. Even with suboptimal imaging, its ease of use makes it an invaluable option for cardiac evaluation, particularly in time-sensitive or resource-constrained clinical settings.

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