Mitral annular motion as a surrogate for left ventricular ejection fraction: real-time three-dimensional echocardiography and magnetic resonance imaging studies

Abstract

Aims: To validate the accuracy of mitral annular motion assessed by real-time three-dimensional echocardiography (RT3DE) as a surrogate for determination of the left ventricular function in comparison with magnetic resonance imaging (MRI). Methods and results: Forty-seven patients with a variety of cardiac pathologies underwent both RT3DE and MRI exams. After 3D data sets were transferred to a PC with a custom-made program, nine consecutive rotational apical plane images (20° apart) were displayed. The two mitral leaflet insertion points were manually identified in each plane. The geometry of the mitral annulus was reconstructed from a total of 18 coordinates ( x , y , z ), and the changes in mitral annular area and mitral annular motion along the apical long axis were calculated. The left ventricular ejection fraction (LVEF) determined by MRI was 41±18%, and 24 patients had LVEFy ) obtained by RT3DE was 11 ± 5 mm and correlated moderately well with LVEF ( x ) measured by MRI ( r = 0.84, y = 0.25 x +0.43, p Conclusion: Mitral annular motion determined by RT3DE correlated moderately well with LVEF; and systolic motion, <12 mm, accurately detected LV dysfunction.