TY - JOUR
T1 - Fixed-apex Mitral Annular Descent Correlates Better with Left Ventricular Systolic Function than Does Free-apex Left Ventricular Long-axis Shortening
AU - Rodriguez, Filiberto
AU - Tibayan, Frederick A.
AU - Glasson, Julie R.
AU - Liang, David
AU - Daughters, George T.
AU - Ingels, Neil B.
AU - Miller, D. Craig
PY - 2004/2
Y1 - 2004/2
N2 - 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.
AB - 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.
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U2 - 10.1016/j.echo.2003.11.007
DO - 10.1016/j.echo.2003.11.007
M3 - Article
C2 - 14752482
AN - SCOPUS:0842343427
SN - 0894-7317
VL - 17
SP - 101
EP - 107
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 2
ER -