Mitral annular plane systolic excursion and tricuspid annular plane systolic excursion for risk stratification of acute pulmonary embolism.

Echocardiography
Jason MatosBrett J Carroll

Abstract

Risk stratification for acute pulmonary embolism (PE) incorporates metrics of right ventricle (RV) function. Significant RV dysfunction influences left ventricular (LV) function, though LV function metrics are not utilized for stratifying outcomes in patients with PE. Mitral annular plane systolic excursion (MAPSE) is a linear echocardiographic (TTE) measure that evaluates longitudinal LV function and may aid in risk stratification for acute PE. Using a single-center database of patients with PE from 2007 to 2014, MAPSE was calculated for all TTE's available with sufficient quality (n = 362). A MAPSE of ≥11 mm was used as a normal reference. Thirty-day adverse outcomes were defined as administration of vasopressor, fibrinolytic therapy, open embolectomy, or 30-day PE-related mortality. Odds ratios (OR) and adjusted OR (AOR) were calculated using logistic regression analysis. Tricuspid annular plane systolic excursion (TAPSE) measurements were incorporated to determine the additive benefit of MAPSE. Compared with the reference MAPSE ≥ 11 mm and LVEF > 50%, patients with MAPSE < 11 mm and an LVEF > 50% had worse outcomes (AOR 2.94 [95% CI: 1.08-7.98], P = 0.035). Among patients with LVEF > 50%, the presence of both a MAPSE < 11 m...Continue Reading

References

Sep 16, 2009·Congestive Heart Failure·Navin RajagopalanAngel López-Candales
Sep 15, 2010·Circulation·Gregory Piazza, Samuel Z Goldhaber
Jul 17, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Jason MatosGila Perk
Nov 6, 2012·Heart and Vessels·Hirohisa AmanoTeruo Inoue
Jan 15, 2014·JACC. Cardiovascular Imaging·Piotr PruszczykAnna Wyzgal
Jun 19, 2014·JAMA : the Journal of the American Medical Association·Saurav ChatterjeeJay Giri
Aug 10, 2016·Circulation·Lynne T BraunUNKNOWN American Heart Association Advocacy Coordinating Committee
May 22, 2018·The American Journal of Cardiology·Brett J CarrollWarren J Manning

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