27. New echocardiogram index alternatives to MAPSE and TAPSE z-scores in children

• Main Authors: Ziad Issa, Nasser Moiduddin, Ziad Rafic Al Bulbul, Giovanni Di Salvo
• Format: Article
• Language: English
• Published: Saudi Heart Association 2015-10-01
• Series: Journal of the Saudi Heart Association
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731515002675

Mitral annular plane systolic excursion (MAPSE), and tricuspid annular plane systolic excursion (TAPSE) are relatively load independent longitudinal left ventricle (LV) and right ventricle (RV) measurement in both adults and children. Normal paediatric values of MAPSE and TAPSE unlike adults are based on inconvenient z-scores. We hypothesize novel indexes of (LSI) LV longitudinal systolic index and (RSI) RV longitudinal systolic index are BSA, age, gender independent and nullifies the need for MAPSE and TAPSE z-scores. Methods: Normal echocardiograms were retrospectively reviewed from 2009 to 2011. Ejection fraction, LV dimensions, MAPSE, and TAPSE were determined. LSI and RSI were calculated using MAPSE and TAPSE divided by LV length. Echocardiogram indices were correlated. Regression analysis was done for BSA, age, and gender. Results: Two hundred and one patients had normal ejection fractions (67.3;± 5.1%). Mean MAPSE 10.4;± 3.3 mm, z-score −0.07;± 1.2, and LSI 0.20;± 0.03; Mean TAPSE 17.4;± 5.4 mm, z-score 0.74;± 1.7, and RSI 0.34;± 0.06. LSI and MAPSE z-scores correlated, r = 0.73, p < 0.001. Age, gender, and BSA did not correlate with LSI. RSI and TAPSE z-scores correlated with r = 0.76, p < 0.001. Age influences RSI, R2 = 0.58, p value <0.001, BSA and gender does not. RSI, with age stratification, is significantly decreased less than 2 months. Conclusion: LSI obviates need for-MAPSE z scores. RSI offers an additional non TAPSE z-score method to evaluate RV function, but does not nullify age effect. RSI, especially in the first two months is decreased.