Estimation of Cardiac Systolic Function Based on Mitral Valve Movements: An Accurate Bedside Tool for Emergency Physicians in Dyspneic Patients

• Published in: Journal of ultrasound in medicine 2019-04, Vol.38 (4), p.1027-1038
• Main Authors: Satılmış Siliv, Neslihan, Yamanoglu, Adnan, Pınar, Pelin, Celebi Yamanoglu, Nalan Gokce, Torlak, Fatih, Parlak, Ismet
• Format: Article
• Language: English
• Subjects: bedside sonography; echocardiography; E‐point septal separation; left ventricular ejection fraction; left ventricular systolic function
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.14791

Objectives The purpose of this study was to determine the success of mitral valve movements in the estimation of left ventricular ejection fraction (LVEF). Methods Adult patients whose principal symptom was dyspnea were included in this prospective observational study. The distance from the anterior mitral valve (AMV) to the interventricular septum (IVS) during early diastole was measured first in B‐mode in the parasternal long axis (PLAX) named parasternal long axis–anterior leaflet septal separation. Second, the AMV‐IVS distance was measured in M‐mode in the PLAX named E‐point septal separation. Third, AMV‐IVS distance was measured in B‐mode in the apical 4‐chamber view named apical 4‐chamber view–anterior leaflet septal separation. Finally, maximum distance between the 2 mitral leaflets in the apical 4‐chamber view was measured and named mitral valve leaflet separation. Comprehensive echocardiography was performed by an experienced cardiologist. Correlation was calculated between mitral valve measurements and LVEF. Cutoff values were determined using receiver operating characteristic curves and the chi‐square test. Results A total of 118 patients were included in the study. Parasternal long axis–anterior leaflet septal separation, E‐point septal separation, and apical 4‐chamber view–anterior leaflet septal separation were highly correlated with LVEF (correlation coefficient, −0.848, −0.833, and−0.822 [P