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Quantification of mitral annular excursion from cine MRI and validated by Doppler echocardiography
Journal of Cardiovascular Magnetic Resonance volume 16, Article number: P20 (2014)
Mitral annular plane systolic excursion (MAPSE) reflects longitudinal left ventricular function, predicts survival in heart failure patients and provides a sensitive marker of early systolic dysfunction in hypertensive patients with normal ejection fraction (EF). Doppler mitral annulus velocity (e') in early diastole predicts cardiac mortality, differentiates diseases and estimates filling pressures. We present a practical technique that facilitates measuring atrioventricular junction (AVJ) motion throughout the cardiac cycle from cine cardiac magnetic resonance (CMR) and correlate these measurements with EF and echocardiography-determined e'.
Twenty-seven patients underwent CMR and transthoracic echocardiography (TTE) within 24 hours, between June 2010 and September 2013. Using custom-written MATLAB software we tracked AVJ motion throughout the cardiac cycle, using 4-chamber cine images (Figure 1). The longitudinal AVJ displacement was plotted as a function of time, and maximum systolic displacement and early diastolic velocity were determined (Figures 1 and 2). Three separate tissue Doppler echocardiography (TDE) measurements of lateral e' were averaged. Pearson's correlations between the maximum longitudinal displacement (MD) of the AVJ and CMR-derived EF, as well as the maximum velocity of the AVJ in early diastole (MVED) and e' were calculated.
Seventeen woman and 10 men with a mean age of 59 (range 36-82) underwent CMR and TTE. Mean values for CMR-derived EF and TDE e' were found to be 53% (range 28-71% and 11 cm/s (range 3-18 cm/s), respectively. Moderate correlations were found between MVED and e' (r = 0.624, p = 0.001) as well as EF and MD (r = 0.486, p = 0.01). A moderate correlation was also found for MD and left ventricular stroke volume (r = 0.504, p = 0.007). Atrioventricular junction analysis was performed offline and took approximately 10 minutes per patient.
Atrioventricular junction analysis is a practical CMR technique that yields CMR measurements of diastolic and systolic function. A moderately strong correlation was found between CMR-derived MVED and e', as well as EF and MD.
Supported by the National Heart, Lung and Blood Institute, National Institutes of Health by the Division of Intramural Research, NHLBI, NIH, DHHS.
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Saba, S.G., Sachdev, V., Hannoush, H. et al. Quantification of mitral annular excursion from cine MRI and validated by Doppler echocardiography. J Cardiovasc Magn Reson 16, P20 (2014). https://doi.org/10.1186/1532-429X-16-S1-P20
- Cardiac Magnetic Resonance
- Early Diastole
- Tissue Doppler Echocardiography
- Ventricular Stroke Volume
- Mitral Annular Plane Systolic Excursion