title: Mitral annular plane systolic excursion/left ventricular length (MAPSE/L) as a simple index for assessing left ventricular longitudinal function in children.
abstract: BACKGROUND
  Assessment of longitudinal left ventricular (LV) function is important for early detection of cardiac dysfunction. Although mitral annular plane systolic excursion (MAPSE) obtained by M-mode echocardiography offers a simple method for assessing longitudinal LV function, normal values of MAPSE for children change according to body size.
  
  
  METHODS
  To minimize the effects of body size, MAPSE was divided by LV long-axis length (MAPSE/L). MAPSE/L was measured in 210 healthy children from birth to 15 years of age and classified into five subgroups. MAPSE/L was then compared with 10 parameters in 136 children (age, heart rate, mean blood pressure, ejection fraction of the LV (EF), peak atrial flow velocity/peak early diastolic flow velocity of mitral flow, tissue Doppler velocity during systole (s') and early diastole (e'), E/e' ratio, Tei index, and global longitudinal strain (GLS) of the LV by the speckle tracking method).
  
  
  RESULTS
  MAPSE/L was significantly lower in the neonate group than in the remaining four groups. MAPSE/L then increased with age to peak at 1-5 years and gradually decreased thereafter. In all cases beyond the neonatal period, MAPSE/L was more than 0.17. Among various parameters, GLS, age, EF, Tei index and s' were significantly associated with MAPSE/L in that order. In univariate analysis, GLS was most significantly associated with MAPSE/L (r=.56).
  
  
  CONCLUSIONS
  We have established normal reference values for MPSE/L in healthy children. MAPSE/L is expected to offer a simple parameter to evaluate LV longitudinal systolic function during daily routine echocardiography in children.
authors.affiliation: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Terada
authors.affiliation: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan.
authors.forename: Hayabuchi
authors.initials: H
authors.lastname: Yasunobu
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D049628:Body Size; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology; D011446:Prospective Studies; D012016:Reference Values; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: 
  MAPSE
  ; MAPSE/L; global strain; longitudinal LV function; speckle tracking