title: Mitral annulus motion compared with wall motion scoring index in the assessment of left ventricular ejection fraction.
abstract: The biplane disc summation method is the recommended echocardiographic procedure to determine left ventricular (LV) ejection fraction (EF). Assessment of mitral annulus motion (MAM) or wall motion scoring index (WMI) has been reported to be less dependent on image quality compared with the recommended method, and proposed as a surrogate to the disc summation method in calculation of LVEF. We aimed to compare MAM and WMI in the echocardiographic assessment of LVEF. In a randomly selected population-based sample of 75-year-old men and women in sinus rhythm (n = 409) MAM, as measured by M-mode, was compared with WMI, calculated as the mean value of wall motion scoring in 9 LV segments. LVEF, as measured by the biplane disc summation method was used as reference. The limits of agreement (mean difference +/- 1.96 SD) between LVEF and corresponding MAM values were -18 to +13 LVEF%, and between LVEF and corresponding WMI values were -12 to +13 LVEF%. The areas under the receiver operating characteristic curves for MAM and WMI to predict a LVEF < 50% were 0.892 and 0.998, respectively (95% confidence interval of the difference 0.062-0.149). The corresponding areas for MAM and WMI to predict a LVEF < 40% were 0.955 and 0.998, respectively (95% confidence interval of the difference 0.017-0.069). In conclusion, the ability of WMI to estimate LVEF was more favorable than MAM in this population-based sample of 75-year-old participants. The findings suggest that the WMI is preferable to MAM in estimating LVEF.
authors.affiliation: Department of Clinical Physiology, Division of Cardiology, University of Uppsala, Central Hospital, Västerås, Sweden. par.o.hedberg@ltvastmanland.se
authors.forename: Pär
authors.initials: P
authors.lastname: Hedberg
authors.forename: Tommy
authors.initials: T
authors.lastname: Jonason
authors.forename: Egil
authors.initials: E
authors.lastname: Henriksen
authors.forename: Ingemar
authors.initials: I
authors.lastname: Lönnberg
authors.forename: Göran
authors.initials: G
authors.lastname: Nilsson
authors.forename: Kenneth
authors.initials: K
authors.lastname: Pehrsson
authors.forename: Ivar
authors.initials: I
authors.lastname: Ringqvist
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology; D009200:Myocardial Contraction / Q000502:physiology*; D013318:Stroke Volume