Ochs Marco M, Fritz Thomas, André Florian, Riffel Johannes, Mereles Derliz, Müller-Hennessen Matthias, Giannitsis Evangelos, Katus Hugo A, Friedrich Matthias G, Buss Sebastian J
Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
Int J Cardiovasc Imaging. 2017 May;33(5):721-729. doi: 10.1007/s10554-016-1058-y. Epub 2017 Jan 21.
Cardiac valve plane displacement (CVPD) reflects longitudinal LV function. The purpose of the present study was to determine regional heterogeneity of CVPD in healthy adults to provide normal values by cardiac magnetic resonance (CMR). We measured the anterior aortic plane systolic excursion (AAPSE); the anterior, anterolateral, inferolateral, inferior, and inferoseptal mitral annular plane systolic excursion (MAPSE); and the lateral tricuspid annulus plane systolic excursion (TAPSE). Systolic excursion was measured as the distance from peak end-diastolic to peak end-sysstolic annular position (peak-to-peak) in cine images acquired in 2-, 3- and 4-chamber views. Echocardiographic measurements of CVPD were performed in M-Mode as previously described. We retrospectively analyzed 209 healthy Caucasians (57% men), who participated in the Heidelberg normal cohort between March 2009 and September 2014. The analysis was possible in all participants. Mean values were: AAPSE = 14 ± 3 mm (8-20); MAPSE = 14 ± 3 mm (8-20); MAPSE = 16 ± 3 mm (10-22); MAPSE = 16 ± 3 mm (10-22); MAPSE = 17 ± 3 mm (11-23); MAPSE = 13 ± 3 mm (7-19) and TAPSE = 26 ± 4 mm (18-34) respectively. MAPSE was significantly elevated in lateral compared to septal regions (p = 0.0001). Sex-differences for CVPD were not found. Age-dependency of CVPD revealed distinct regional differences. AAPSE decreased the most with age (B=-0.48; p = 0.0001), whereas MAPSE was the least age-dependent site (B=-0.17; p = 0.01). AAPSE revealed favorable intra-/interobserver reproducibility and interstudy agreement. Intermethod-comparison of CMR and M-Mode echocardiography showed good agreement between both measurements of CVPD. Age-stratified normal values of regional CVPD are provided. AAPSE revealed the most pronounced age-related decrease and provided favorable reproducibility compared to other regions of cardiac valve plane.
心脏瓣膜平面位移（CVPD）反映左心室纵向功能。本研究的目的是通过心脏磁共振成像（CMR）确定健康成年人CVPD的区域异质性，以提供正常值。我们测量了主动脉前平面收缩期偏移（AAPSE）；二尖瓣前、前外侧、下外侧、下和下间隔环平面收缩期偏移（MAPSE）；以及三尖瓣环外侧平面收缩期偏移（TAPSE）。收缩期偏移测量为在二腔、三腔和四腔视图中采集的电影图像中从舒张末期峰值到收缩末期峰值环位置（峰到峰）的距离。CVPD的超声心动图测量如前所述在M型模式下进行。我们回顾性分析了2009年3月至2014年9月期间参与海德堡正常队列的209名健康白种人（57%为男性）。所有参与者均进行了分析。平均值分别为：AAPSE = 14±3毫米（8 - 20）；MAPSE = 14±3毫米（8 - 20）；MAPSE = 16±3毫米（10 - 22）；MAPSE = 16±3毫米（10 - 22）；MAPSE = 17±3毫米（11 - 23）；MAPSE = 13±3毫米（7 - 19）和TAPSE = 26±4毫米（18 - 34）。与间隔区域相比，外侧的MAPSE显著升高（p = 0.0001）。未发现CVPD的性别差异。CVPD的年龄依赖性显示出明显的区域差异。AAPSE随年龄下降最为明显（B = -0.48；p = 0.0001），而MAPSE是年龄依赖性最小的部位（B = -0.17；p = 0.01）。AAPSE显示出良好的观察者内/间重复性和研究间一致性。CMR和M型超声心动图的方法间比较显示，两者在CVPD测量上具有良好的一致性。提供了区域CVPD的年龄分层正常值。与心脏瓣膜平面的其他区域相比，AAPSE显示出最明显的与年龄相关的下降，并具有良好的重复性。
