INTRODUCTION: The accurate measurement of Left Ventricular Ejection Fraction (LVEF) requires high-quality images and echocardiography expertise. Critically ill patients can present challenges in obtaining good acoustic windows for ultrasound, particularly for ICU trainees early in their ultrasound learning. Mitral Annular Plane Systolic Excursion (MAPSE), a simple measurement, may be useful in this context to estimate LV systolic function. MATERIALS AND METHODS: All adult patients admitted to the Alfred ICU between August 2012 and February 2013 who were on mechanical ventilation and needed an echocardiography examination were eligible to be included in the study. An ICU trainee in their first year of echocardiography training performed MAPSE measurements. An advanced echocardiographer classified LV systolic function into normal, mild, moderate or severe categories based on the visual estimation of LVEF. The relationship between the MAPSE measurements and the range of LV systolic function was assessed. RESULTS: Amongst 39 patients, the mean (SD) age was 55 (18.6) years, 20 (50%) were males, 36 (90%) were in sinus rhythm, 19 (48%) were on vasopressors, 12 (30%) were on inotropes and 23 (58%) were on mandatory mode mechanical ventilation. The mean (SD) MAPSE was 12.2 (5.28) mm. 28 (70%) of the patients had normal or mildly reduced LVEF. The ROC analysis showed that a MAPSE cut-off point of ≥12.5 mm diagnosed normal or mildly reduced LVEF with 82.14% sensitivity and 91.67% specificity. The area under ROC curve was 0.91 (95% CI 0.82-1.00). CONCLUSION: MAPSE is useful as a surrogate for LVEF in mechanically ventilated patients. In early critical care echocardiography training, a novice learner can perform MAPSE easily, accurately, and find it helpful for assessment of LVEF.
INTRODUCTION: The accurate measurement of Left Ventricular Ejection Fraction (LVEF) requires high-quality images and echocardiography expertise. Critically ill patients can present challenges in obtaining good acoustic windows for ultrasound, particularly for ICU trainees early in their ultrasound learning. Mitral Annular Plane Systolic Excursion (MAPSE), a simple measurement, may be useful in this context to estimate LV systolic function. MATERIALS AND METHODS: All adult patients admitted to the Alfred ICU between August 2012 and February 2013 who were on mechanical ventilation and needed an echocardiography examination were eligible to be included in the study. An ICU trainee in their first year of echocardiography training performed MAPSE measurements. An advanced echocardiographer classified LV systolic function into normal, mild, moderate or severe categories based on the visual estimation of LVEF. The relationship between the MAPSE measurements and the range of LV systolic function was assessed. RESULTS: Amongst 39 patients, the mean (SD) age was 55 (18.6) years, 20 (50%) were males, 36 (90%) were in sinus rhythm, 19 (48%) were on vasopressors, 12 (30%) were on inotropes and 23 (58%) were on mandatory mode mechanical ventilation. The mean (SD) MAPSE was 12.2 (5.28) mm. 28 (70%) of the patients had normal or mildly reduced LVEF. The ROC analysis showed that a MAPSE cut-off point of ≥12.5 mm diagnosed normal or mildly reduced LVEF with 82.14% sensitivity and 91.67% specificity. The area under ROC curve was 0.91 (95% CI 0.82-1.00). CONCLUSION: MAPSE is useful as a surrogate for LVEF in mechanically ventilated patients. In early critical care echocardiography training, a novice learner can perform MAPSE easily, accurately, and find it helpful for assessment of LVEF.
Authors: Yu Ting Tan; Frauke Wenzelburger; Eveline Lee; Grant Heatlie; Francisco Leyva; Kiran Patel; Michael Frenneaux; John E Sanderson Journal: J Am Coll Cardiol Date: 2009-06-30 Impact factor: 24.094
Authors: Lill Bergenzaun; Hans Ohlin; Petri Gudmundsson; Ronnie Willenheimer; Michelle S Chew Journal: Cardiovasc Ultrasound Date: 2013-05-30 Impact factor: 2.062