:2197 (15 May 2021) DOI:10.22122/arya.v17i0.2197

Assessment of tissue mitral annular displacement in patients with coronary artery stenosis

Hoorak Poorzand, Hamidreza Alborz, Hedieh Alimi, Maryam Emadzadeh

DOI: http://dx.doi.org/10.22122/arya.v17i0.2197


BACKGROUND: The high incidence of coronary heart diseases requires early diagnosis to prevent complications. This study aims to assess the mean value of tissue mitral annular displacement (TMAD), using Speckle tracking echocardiography (2D STE) in patients with coronary artery stenosis.

METHODS: 149 patients aged 50 to 76 years were included in this cross-sectional study who were admitted with primary diagnosis of acute coronary syndrome (ACS) to the emergency department. In all patients, the TMAD data were measured using 2D speckle tracking technology.

RESULTS: 149 patients with a mean age of 61.83 ± 7.14 years old were studied. Regarding the involved coronary artery as left anterior descending (LAD), right coronary artery (RCA), or left circumflex artery (LCX), the TMAD data was reduced significantly (P < 0.001) in the relevant walls [base of anterior and anteroseptum (4.46 ± 3.53 mm), base of inferior and inferoseptum (4.91 ± 3.81 mm), and base anterolateral and inferolateral walls (5.53 ± 3.827 mm), respectively.] TMAD in anterior, inferior, and lateral ST-elevation myocardial infarction (STEMI) were 2.64 ± 0.870, 4.78 ± 3.8, and 2.80 ± 0.83 mm, respectively which were significantly reduced compared to the non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (P < 0.001). TMAD in different LV function categories was only reduced in those with LAD lesion and with severe LV systolic dysfunction (2.47 ± 0.834 mm, P < 0.001).

CONCLUSION: The current study describes a significant relationship between TMAD and left ventricular function, ACS type, and the culprit coronary artery. In different types of ACS, the TMAD value was worse in the subgroups of STEMI and in the walls affected by the stenosed coronary artery. This method might be helpful in defining the culprit coronary artery.



Acute Coronary Syndrome; Echocardiography; Left Ventricular Function; Coronary Stenosis

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Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, et al. Heart disease and stroke statistics-2008 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008; 117(4): e25-146.

Lloyd-Jones DM, Larson MG, Beiser A, Levy D. Lifetime risk of developing coronary heart disease. Lancet 1999; 353(9147): 89-92.

Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J 2014; 35(42): 2929.

Kreatsoulas C, Shannon HS, Giacomini M, Velianou JL, Anand SS. Reconstructing angina: Cardiac symptoms are the same in women and men. JAMA Intern Med 2013; 173(9): 829-31.

Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics--2010 update: A report from the American Heart Association. Circulation 2010; 121(7): e46-e215.

Beaglehole R, Reddy S, Leeder SR. Poverty and human development: The global implications of cardiovascular disease. Circulation 2007; 116(17): 1871-3.

Timek TA, Miller DC. Experimental and clinical assessment of mitral annular area and dynamics: What are we actually measuring? Ann Thorac Surg 2001; 72(3): 966-74.

Zahid W, Johnson J, Westholm C, Eek CH, Haugaa KH, Smedsrud MK, et al. Mitral annular displacement by Doppler tissue imaging may identify coronary occlusion and predict mortality in patients with non-ST-elevation myocardial infarction. J Am Soc Echocardiogr 2013; 26(8): 875-84.

Black DE, Bryant J, Peebles C, Godfrey KM, Hanson M, Vettukattil JJ. Tissue motion annular displacement of the mitral valve using two-dimensional speckle tracking echocardiography predicts the left ventricular ejection fraction in normal children. Cardiol Young 2014; 24(4): 640-8.

Dawood FA, Rahmat RW, Kadiman SB, Abdullah LN, Zamrin MD. Measurements of Mitral Annular Displacement in 2D Echocardiography Images. Am J Appl Sci 2015; 12(5): 295-303.

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: A report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18(12): 1440-63.

Bhatt DL. Cardiovascular intervention: A companion to braunwald's heart disease e-book. Philadelphia, PA: Elsevier Health Sciences; 2015.

DeCara JM, Toledo E, Salgo IS, Lammertin G, Weinert L, Lang RM. Evaluation of left ventricular systolic function using automated angle-independent motion tracking of mitral annular displacement. J Am Soc Echocardiogr 2005; 18(12): 1266-9.

Ito K, Noma M, Mohri M, Abe K, Yamamoto U, Kikuchi K, et al. Mitral annulus displacement measured by tissue-tracking method with Doppler-tissue images is a useful marker of the severity of heart failure. J Cardiol 2007; 50(3): 159-66.

Luo J, Zhou AY. Tissue motion mitral annular displacement in evaluation on mitral annular displacement for left ventricular systolic function and degree of reduced cardiac function. Chinese Journal of Medical Imaging Technology 2012; 28(5): 907-10.

Sharif D, Sharif-Rasslan A, Shahla C, Rosenschein U. Application of mitral annular systolic displacements and velocities for the evaluation of left ventricular systolic function and reserve. Cardiol Res 2011; 2(1): 36-41.


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