title: A comprehensive analysis of cardiac valve plane displacement in healthy adults: age-stratified normal values by cardiac magnetic resonance.
abstract: Cardiac valve plane displacement (CVPD) reflects longitudinal LV function. The purpose of the present study was to determine regional heterogeneity of CVPD in healthy adults to provide normal values by cardiac magnetic resonance (CMR). We measured the anterior aortic plane systolic excursion (AAPSE); the anterior, anterolateral, inferolateral, inferior, and inferoseptal mitral annular plane systolic excursion (MAPSE); and the lateral tricuspid annulus plane systolic excursion (TAPSE). Systolic excursion was measured as the distance from peak end-diastolic to peak end-sysstolic annular position (peak-to-peak) in cine images acquired in 2-, 3- and 4-chamber views. Echocardiographic measurements of CVPD were performed in M-Mode as previously described. We retrospectively analyzed 209 healthy Caucasians (57% men), who participated in the Heidelberg normal cohort between March 2009 and September 2014. The analysis was possible in all participants. Mean values were: AAPSE = 14 ± 3 mm (8-20); MAPSEanterior= 14 ± 3 mm (8-20); MAPSEanterolateral= 16 ± 3 mm (10-22); MAPSEinferolateral= 16 ± 3 mm (10-22); MAPSEinferior= 17 ± 3 mm (11-23); MAPSEinferoseptal= 13 ± 3 mm (7-19) and TAPSE = 26 ± 4 mm (18-34) respectively. MAPSE was significantly elevated in lateral compared to septal regions (p = 0.0001). Sex-differences for CVPD were not found. Age-dependency of CVPD revealed distinct regional differences. AAPSE decreased the most with age (B=-0.48; p = 0.0001), whereas MAPSEinferiorwas the least age-dependent site (B=-0.17; p = 0.01). AAPSE revealed favorable intra-/interobserver reproducibility and interstudy agreement. Intermethod-comparison of CMR and M-Mode echocardiography showed good agreement between both measurements of CVPD. Age-stratified normal values of regional CVPD are provided. AAPSE revealed the most pronounced age-related decrease and provided favorable reproducibility compared to other regions of cardiac valve plane.
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany. marco.ochs@med.uni-heidelberg.de.
authors.forename: Marco M
authors.initials: MM
authors.lastname: Ochs
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritz
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: André
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Riffel
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Müller-Hennessen
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Matthias G
authors.initials: MG
authors.lastname: Friedrich
authors.affiliation: Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Buss
mesh_terms: D000328:Adult; D017677:Age Distribution; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000502:physiology; D004452:Echocardiography; D005260:Female; D005858:Germany; D064368:Healthy Volunteers; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology; D015588:Observer Variation; D011237:Predictive Value of Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000502:physiology; D016277:Ventricular Function, Left; D044465:White People
keywords: Anterior aortic plane systolic excursion; Cardiovascular magnetic resonance; Normal values; Valve plane excursion