Adel Walaa, Roushdy Alaa M, Nabil Mohamed
Cardiology Department, Ain Shams University Hospital, Cairo, Egypt.
Echocardiography. 2016 Feb;33(2):179-84. doi: 10.1111/echo.13009. Epub 2015 Jul 14.
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.
验证一种基于二尖瓣环平面收缩期位移（MAPSE）的公式，用于计算左心室（LV）功能不全成年男性的射血分数，即EF = 4.8×MAPSE（mm）+ 5.8。
超声心动图评估左心室功能通常需要专业的超声心动图医生，且具有一定主观性，容易出现读者之间的差异。MAPSE已被建议作为左心室功能的替代测量指标。
对170例男性收缩功能不全患者进行二维经胸超声心动图前瞻性分析。测量通过定性视觉检查、M型和双平面改良辛普森法则测得的MAPSE和射血分数。使用布兰德-奥特曼分析和独立t检验，将基于MAPSE得出的EF与其他测量EF的传统方法进行比较。
平均MAPSE与通过M型测量的EF（r = 0.554，P < 0.001）、辛普森法则（r = 0.585，P < 0.001）和视觉检查（r = 0.611，P < 0.001）之间存在显著正相关。平均MAPSE截止值≤5时，预测EF < 30%的敏感性（67.1%）和特异性（76.5%）达到最佳平衡。基于MAPSE得出的EF与通过视觉检查和辛普森方法测得的EF之间的平均差异分别为3.86±5.24%和3.57±5.97%。基于MAPSE得出的EF与M型测量的EF之间的平均差异最小，为0.5±5.69%（P值0.2）。
使用公式EF = 4.8×MAPSE（mm）+ 5.8基于MAPSE得出的EF，对于左心室EF严重受损的成年男性是一种有效的技术。
