Study of quantitative assessment of left ventricular systolic function by tissue motion annular displacement in heart failure patients

Objective:To evaluate the ability of tissue motion annular displacement(TMAD) for assessment of global left ventricular systolic function in patients with heart failure(HF). Method:The HF group and the control group were composed of 18 patients with HF and 16 healthy subjects respectively.Apical two-,three-and four-chamber views were used to observe the mitral annulus motion of six sites(posteroseptal,lateral,inferior,anterior,posterior and anteroseptal annulus).TMAD parameters including maximal systolic displacement(Ds),time intervals from R wave to maximal systolic displacement(Ts-%) and standard deviation of Ts of six sites(Ts-SD) were measured.Velocity-time integral of S wave and systolic peak velocity were determined by pulsed wave-Doppler tissue imaging(PW-DTI).Left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV) and end diastolic volume(LVEDV) were determined by two-dimensional echocardiography.The correlation between mitral annular motion parameters and LVEF were analyzed. Result:①TMAD depicts mitral annular displacement-time curve as a irregular shape in the HF group.Compared to the control group,Ds was decreased significantly(P0.01).There were significant statistical differences between the HF group and the control group in Ts and Ts-SD(P0.01).②There was a high correlation between the mean Ds of six sites and LVEF while it was poorly correlated to LVESV and LVEDV in the HF group.③A positive correlation was found between mitral annular displacement determined by TMAD and PW-DTI. Conclusion:①TMAD depicts mitral annular displacement-time curve as a irregular shape in patients with HF.The mitral annular displacement decreases significantly.The motions of six annular sites are delayed and not coordinated.②The positive correlation between TMAD parameters and LVEF indicates its value as a novel descriptor of global left ventricular systolic function in heart failure.