Correlation of mitral annular plane systolic excursion (mapse) with left ventricular global longitudinal strain (gls) in patients undergoing coronary artery bypass surgery

Introduction Introduction:Global longitudinal strain (GLS) of left ventricle (LV) has an incremental value over conventional parameters like ejection fraction for risk stratification in patients referred for cardiac surgery [1]. Mitral annular plane systolic excursion is a simple parameter obtained by M mode, is also an sensitive marker of LV function in various clinical settings [2]. It has been demonstrated that, MAPSE and GLS has similar biological variability in healthy population[3]. The aim of this study was to assess correlation of MAPSE and GLS in patients with ischemic heart disease undergoing coronary artery bypass surgery (CABG). Methods This was a retrospective study of 51 patients undergoing CABG. A cardiac anesthetist performed transthoracic echocardiography exam within 24 hours of surgery. GLS was measured by three apical views: 4-chamber, 2-chamber and long axis view and average value measured. Average MAPSE was obtained in apical 4-chamber view by aligning M mode cursor at lateral and septal mitral annulus and averaging the two values. Measurements of GLS and MAPSE in a sample patient are shown in figure 1. A Pearson's product-moment correlation was run to assess the relationship between MAPSE and GLS. Results The average age of patients was 60 years with 26% females. The average mean GLS was -12.8 -2.9% and average MAPSE was 10 1.9mm. Figure 2 shows Pearson's product-moment correlation between two parameters, demonstrating a strong positive correlation with corelation coefficient, r= 0.83 (p < .0005). Conclusion MPASE and GLS are significantly correlated in patients undergoing CABG and MAPSE being simple parameter can be used as surrogate marker for GLS.