Fixed-apex Mitral Annular Descent Correlates Better with Left Ventricular Systolic Function than Does Free-apex Left Ventricular Long-axis Shortening

Filiberto Rodriguez, Frederick A. Tibayan, Julie R. Glasson, David Liang, George T. Daughters, Neil B. Ingels, D. Craig Miller

    Research output: Contribution to journalArticle

    7 Scopus citations

    Abstract

    Echocardiographic measures of mitral annular descent (MAD) assume a fixed left ventricular (LV) apex throughout the cardiac cycle, ignoring the apical component of LV long-axis shortening (LAS). We tested whether apical motion contributes significantly to LAS, making LAS a better surrogate of LV systolic function than MAD. Three-dimensional LV systolic MAD, LAS, and apical motion were measured in sheep using implanted radiopaque markers and biplane videofluoroscopy. End-diastolic volume-stroke work relationship (preload recruitable stroke work) was computed as a load-independent index of LV systolic function. Apical motion was 1.4 ± 0.8 mm, representing 22% of LAS (P < .05). Linear regression demonstrated that MAD correlated slightly better with preload recruitable stroke work (r = 0.808) than LAS (r = 0.792, both P < .001). Receiver operating characteristic curves demonstrated MAD was more accurate in predicting depressed LV function than LAS (93% vs 84%, respectively). Although LV apical motion contributed significantly to LAS, MAD measured with a fixed-apex assumption, as currently done echocardiographically, correlated more closely with LV preload recruitable stroke work.

    Original languageEnglish (US)
    Pages (from-to)101-107
    Number of pages7
    JournalJournal of the American Society of Echocardiography
    Volume17
    Issue number2
    DOIs
    StatePublished - Feb 2004

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Cardiology and Cardiovascular Medicine

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