Mitral annular plane systolic excursion/left ventricular length (MAPSE/L) as a simple index for assessing left ventricular longitudinal function in children

Echocardiography. 2016 Nov;33(11):1703-1709. doi: 10.1111/echo.13325. Epub 2016 Aug 22.

Abstract

Background: Assessment of longitudinal left ventricular (LV) function is important for early detection of cardiac dysfunction. Although mitral annular plane systolic excursion (MAPSE) obtained by M-mode echocardiography offers a simple method for assessing longitudinal LV function, normal values of MAPSE for children change according to body size.

Methods: To minimize the effects of body size, MAPSE was divided by LV long-axis length (MAPSE/L). MAPSE/L was measured in 210 healthy children from birth to 15 years of age and classified into five subgroups. MAPSE/L was then compared with 10 parameters in 136 children (age, heart rate, mean blood pressure, ejection fraction of the LV (EF), peak atrial flow velocity/peak early diastolic flow velocity of mitral flow, tissue Doppler velocity during systole (s') and early diastole (e'), E/e' ratio, Tei index, and global longitudinal strain (GLS) of the LV by the speckle tracking method).

Results: MAPSE/L was significantly lower in the neonate group than in the remaining four groups. MAPSE/L then increased with age to peak at 1-5 years and gradually decreased thereafter. In all cases beyond the neonatal period, MAPSE/L was more than 0.17. Among various parameters, GLS, age, EF, Tei index and s' were significantly associated with MAPSE/L in that order. In univariate analysis, GLS was most significantly associated with MAPSE/L (r=.56).

Conclusions: We have established normal reference values for MPSE/L in healthy children. MAPSE/L is expected to offer a simple parameter to evaluate LV longitudinal systolic function during daily routine echocardiography in children.

Keywords: MAPSE; MAPSE/L; global strain; longitudinal LV function; speckle tracking.

MeSH terms

  • Adolescent
  • Blood Pressure / physiology
  • Body Size
  • Child
  • Child, Preschool
  • Diastole
  • Echocardiography, Doppler / methods*
  • Female
  • Follow-Up Studies
  • Heart Ventricles / diagnostic imaging*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve / physiology
  • Prospective Studies
  • Reference Values
  • Stroke Volume / physiology*
  • Systole
  • Ventricular Function, Left / physiology*