Taşolar Hakan, Mete Türkan, Çetin Mustafa, Altun Burak, Ballı Mehmet, Bayramoğlu Adil, Otlu Yılmaz Ömür
Department of Cardiology, Adıyaman University, Training and Research Hospital; Adıyaman-Turkey.
Anatol J Cardiol. 2015 Jul;15(7):558-64. doi: 10.5152/akd.2014.5561. Epub 2014 Jun 23.
Mitral annular plane systolic excursion (MAPSE) is a simple way to assess left ventricle (LV) function. MAPSE is also correlated to parameters, illustrating the close relation between systolic and diastolic function of LV. In this study, we evaluated whether MAPSE could help us in the determination the LV diastolic dysfunction (DD) in obese adults.
Our study was a prospective cross-sectional study. Obese patients who were referred from the endocrinology clinic were enrolled into this study. The participants included 40 obese patients with early-stage DD (grade I and II) and 40 obese patients with normal diastolic function, with an equal number of males and females. The patients with DD were further divided into Obese DD+I, who had grade I DD, and Obese DD+II, who had grade II DD. Student t-test, Mann-Whitney U test, one-way analysis of variance, ROC curve analysis, and pairwise comparisons of the ROC curves were used for statistical analysis.
MAPSE was different in all groups, with the lowest value in the Obese DD+II group (p<0.001). E/Em ratio was also different among all groups and was highest in the Obese DD+II group (p<0.001). Furthermore, MAPSE was negatively correlated with E/Em ratio (r=-0.368, p=0.020). The optimal threshold point of MAPSE in the diagnosis of left ventricle diastolic dysfunction (LVDD) was ≤1.45 cm, with 92.5% sensitivity (95% CI 79.6-98.4) and 77.5% specificity (95% CI 61.5-89.2) in the ROC curve analysis. There was no difference in the pairwise comparisons of the ROC curves of MAPSE and E/Em ratio in the diagnosis of DD [area under the ROC curve 0.902 (0.033) vs. 0.927 (0.027); p=0.54].
Consequently, we found significantly a close relationship between MAPSE with conventional echocardiographic parameters, especially with E/Em, in the detection of left ventricle diastolic dysfunction (LVDD) in obese adults with normal LV ejection fraction. We think that MAPSE is a simple, easily acquired and less time consuming measurement and may help us in the stratification of LVDD in obese adults.
二尖瓣环平面收缩期位移（MAPSE）是评估左心室（LV）功能的一种简单方法。MAPSE还与一些参数相关，这表明左心室收缩和舒张功能之间存在密切关系。在本研究中，我们评估了MAPSE是否有助于我们确定肥胖成年人的左心室舒张功能障碍（DD）。
我们的研究是一项前瞻性横断面研究。纳入了从内分泌门诊转诊的肥胖患者。参与者包括40例早期DD（I级和II级）肥胖患者和40例舒张功能正常的肥胖患者，男女数量相等。DD患者进一步分为Obese DD+I组（I级DD）和Obese DD+II组（II级DD）。采用学生t检验、曼-惠特尼U检验、单因素方差分析、ROC曲线分析以及ROC曲线的两两比较进行统计分析。
所有组的MAPSE均不同，Obese DD+II组的值最低（p<0.001）。所有组的E/Em比值也不同，Obese DD+II组最高（p<0.001）。此外，MAPSE与E/Em比值呈负相关（r=-0.368，p=0.020）。在ROC曲线分析中，MAPSE诊断左心室舒张功能障碍（LVDD）的最佳阈值点为≤1.45 cm，敏感性为92.5%（95%CI 79.6-98.4），特异性为77.5%（95%CI 61.5-89.2）。在DD诊断中，MAPSE和E/Em比值的ROC曲线两两比较无差异[ROC曲线下面积0.902（0.033）对0.927（0.027）；p=0.54]。
因此，我们发现，在左心室射血分数正常的肥胖成年人中，MAPSE与传统超声心动图参数，尤其是与E/Em之间，在检测左心室舒张功能障碍（LVDD）方面存在显著的密切关系。我们认为MAPSE是一种简单、易于获取且耗时较少的测量方法，可能有助于我们对肥胖成年人的LVDD进行分层。
