Mitral Annular Plane Systolic Excursion (Mapse)

Background and Objectives: Assessment of left ventricle function is the singlemost common indication for transthoracic echocardiogram. Out of different indicators of LVfunction, ejection fraction is the most validated one. MAPSE has promised recently to be a reliableand easily obtainable indicator for LV function even in inexperienced hands but its value in caseof left ventricle hypertrophy (LVH) is questionable. Study Design: Cross-sectional comparativestudy. Setting: Rehmatul-lil-Alameen Institute of Cardiology, Lahore. Period: January 2015and March 2015. Methods: 100 consecutive patients presenting for echocardiography atRehmatul-lil-Alameen Institute of Cardiology, Lahore. Patients were divided into two groups onthe basis of presence of left ventricle hypertrophy (LVMI >115 g/m2 in males and > 95 g/m2in females) and further subdivided according to LVEF into those with preserved (EF>55%) anddepressed EF (EF<55%). EF was calculated by visual quantification (eyeballing). MAPSE wasmeasured using M-mode at all four mitral annular sites-medial, lateral, anterior and posteriorand values averaged. Results: Among 100 patients; 66(66%) were without LVH while 34(34%)were having LVH. Without LVH group had 43 (65%) patients with preserved LVEF (EF>55%)while 23 (35%) had depressed LVEF (EF>55%). In LVH group 22 (64.7%) had preservedLVEF while 12 (35.3%) had depressed LVEF. Mean EF (%), without LVH and preserved LVEF(61.6±3.6), LVH with preserved LVEF (61.9±3.6). Mean EF (%); without LVH and depressedLVEF (41.1±6.4), LVH with depressed LVEF (42.9±5.4), p=0.663. Mean MAPSE score (mm);without LVH with preserved LVEF (13.2±1.7), LVH with preserved LVEF (10.6±0.9), p<0.001.Mean MAPSE score (mm); without LVH and depressed LVEF (9.17±0.9), LVH with depressedLVEF (7.4±1.5), p=0.002. Mann Whitney U test was applied to compare the MAPSE score ofgroups and it showed statistically significant difference in MAPSE score of patients with andwithout left ventricle hypertrophy with values much lower in the presence of LVH. Conclusion:Statistically significant difference exists in values of MAPSE in patients with and without leftventricle hypertrophy irrespective of LV function.