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

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...

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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
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Language:English
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bedside sonography
echocardiography
E‐point septal separation
left ventricular ejection fraction
left ventricular systolic function
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container_title Journal of ultrasound in medicine
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Yamanoglu, Adnan
Pınar, Pelin
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Torlak, Fatih
Parlak, Ismet
description 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 
doi_str_mv 10.1002/jum.14791
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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 &lt; .001]). Parasternal long axis–anterior leaflet septal separation values less than 2.30 mm, E‐point septal separation values less than 2 mm, and mitral valve leaflet separation values greater than 25.15 mm exhibited a 100% negative predictive value in excluding reduced LVEF. Parasternal long axis–anterior leaflet septal separation values less than 4.95 mm, EPSS values less than 5.85 mm, apical 4‐chamber view–anterior leaflet septal separation values less than 6.95 mm, and mitral valve leaflet separation values greater than 24.05 mm exhibited a 100% negative predictive value in excluding severe reduced LVEF. Conclusions Mitral valve measurement methods may be useful in predicting LVEF or values thereof as a complementary method of diagnosing challenging patients on echocardiographic images.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.1002/jum.14791</identifier><identifier>PMID: 30265408</identifier><language>eng</language><publisher>England</publisher><subject>bedside sonography ; echocardiography ; E‐point septal separation ; left ventricular ejection fraction ; left ventricular systolic function</subject><ispartof>Journal of ultrasound in medicine, 2019-04, Vol.38 (4), p.1027-1038</ispartof><rights>2018 by the American Institute of Ultrasound in Medicine</rights><rights>2018 by the American Institute of Ultrasound in Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3251-6544bd657aeb7e0efbc6022c93b88219f4df07380d03cd3e2f06ccf37c18aa133</citedby><cites>FETCH-LOGICAL-c3251-6544bd657aeb7e0efbc6022c93b88219f4df07380d03cd3e2f06ccf37c18aa133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30265408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Satılmış Siliv, Neslihan</creatorcontrib><creatorcontrib>Yamanoglu, Adnan</creatorcontrib><creatorcontrib>Pınar, Pelin</creatorcontrib><creatorcontrib>Celebi Yamanoglu, Nalan Gokce</creatorcontrib><creatorcontrib>Torlak, Fatih</creatorcontrib><creatorcontrib>Parlak, Ismet</creatorcontrib><title>Estimation of Cardiac Systolic Function Based on Mitral Valve Movements: An Accurate Bedside Tool for Emergency Physicians in Dyspneic Patients</title><title>Journal of ultrasound in medicine</title><addtitle>J Ultrasound Med</addtitle><description>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 &lt; .001]). Parasternal long axis–anterior leaflet septal separation values less than 2.30 mm, E‐point septal separation values less than 2 mm, and mitral valve leaflet separation values greater than 25.15 mm exhibited a 100% negative predictive value in excluding reduced LVEF. Parasternal long axis–anterior leaflet septal separation values less than 4.95 mm, EPSS values less than 5.85 mm, apical 4‐chamber view–anterior leaflet septal separation values less than 6.95 mm, and mitral valve leaflet separation values greater than 24.05 mm exhibited a 100% negative predictive value in excluding severe reduced LVEF. Conclusions Mitral valve measurement methods may be useful in predicting LVEF or values thereof as a complementary method of diagnosing challenging patients on echocardiographic images.</description><subject>bedside sonography</subject><subject>echocardiography</subject><subject>E‐point septal separation</subject><subject>left ventricular ejection fraction</subject><subject>left ventricular systolic function</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kMtO4zAUQC3ECDowC34AeQmLtH7kya6UAjOiAmmAbeTY12CU2MVOGOUr-GUMBXazupbu0fHVQeiAkiklhM2ehm5K06KiW2hCs4wkVU75NpoQVpRJyqpiF_0M4SmihBbpDtrlhOVZSsoJel2G3nSiN85ip_FCeGWExH_H0LvWSHw-WPmxPBUBFI6Plem9aPG9aF8Ar9wLdGD7cILnFs-lHLzoAZ-CCkYBvnWuxdp5vOzAP4CVI755HIORRtiAjcVnY1hbiP_cxBPePfvohxZtgF-fcw_dnS9vF5fJ1fXF78X8KpGcZTSJ16eNyrNCQFMAAd3InDAmK96UJaOVTpUmBS-JIlwqDkyTXErNC0lLISjne-ho41179zxA6OvOBAltKyy4IdSM0jSvqrTKInq8QaV3IXjQ9drHZH6sKanf-9exf_3RP7KHn9qh6UB9k1_BIzDbAP9MC-P_TfWfu9VG-Qbln5Dj</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Satılmış Siliv, Neslihan</creator><creator>Yamanoglu, Adnan</creator><creator>Pınar, Pelin</creator><creator>Celebi Yamanoglu, Nalan Gokce</creator><creator>Torlak, Fatih</creator><creator>Parlak, Ismet</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201904</creationdate><title>Estimation of Cardiac Systolic Function Based on Mitral Valve Movements: An Accurate Bedside Tool for Emergency Physicians in Dyspneic Patients</title><author>Satılmış Siliv, Neslihan ; Yamanoglu, Adnan ; Pınar, Pelin ; Celebi Yamanoglu, Nalan Gokce ; Torlak, Fatih ; Parlak, Ismet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3251-6544bd657aeb7e0efbc6022c93b88219f4df07380d03cd3e2f06ccf37c18aa133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>bedside sonography</topic><topic>echocardiography</topic><topic>E‐point septal separation</topic><topic>left ventricular ejection fraction</topic><topic>left ventricular systolic function</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Satılmış Siliv, Neslihan</creatorcontrib><creatorcontrib>Yamanoglu, Adnan</creatorcontrib><creatorcontrib>Pınar, Pelin</creatorcontrib><creatorcontrib>Celebi Yamanoglu, Nalan Gokce</creatorcontrib><creatorcontrib>Torlak, Fatih</creatorcontrib><creatorcontrib>Parlak, Ismet</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Satılmış Siliv, Neslihan</au><au>Yamanoglu, Adnan</au><au>Pınar, Pelin</au><au>Celebi Yamanoglu, Nalan Gokce</au><au>Torlak, Fatih</au><au>Parlak, Ismet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimation of Cardiac Systolic Function Based on Mitral Valve Movements: An Accurate Bedside Tool for Emergency Physicians in Dyspneic Patients</atitle><jtitle>Journal of ultrasound in medicine</jtitle><addtitle>J Ultrasound Med</addtitle><date>2019-04</date><risdate>2019</risdate><volume>38</volume><issue>4</issue><spage>1027</spage><epage>1038</epage><pages>1027-1038</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>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 &lt; .001]). Parasternal long axis–anterior leaflet septal separation values less than 2.30 mm, E‐point septal separation values less than 2 mm, and mitral valve leaflet separation values greater than 25.15 mm exhibited a 100% negative predictive value in excluding reduced LVEF. Parasternal long axis–anterior leaflet septal separation values less than 4.95 mm, EPSS values less than 5.85 mm, apical 4‐chamber view–anterior leaflet septal separation values less than 6.95 mm, and mitral valve leaflet separation values greater than 24.05 mm exhibited a 100% negative predictive value in excluding severe reduced LVEF. Conclusions Mitral valve measurement methods may be useful in predicting LVEF or values thereof as a complementary method of diagnosing challenging patients on echocardiographic images.</abstract><cop>England</cop><pmid>30265408</pmid><doi>10.1002/jum.14791</doi><tpages>12</tpages></addata></record>
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subjects bedside sonography
echocardiography
E‐point septal separation
left ventricular ejection fraction
left ventricular systolic function
title Estimation of Cardiac Systolic Function Based on Mitral Valve Movements: An Accurate Bedside Tool for Emergency Physicians in Dyspneic Patients
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