Atrioventricular plane displacement versus mitral and tricuspid annular plane systolic excursion: a comparison between cardiac magnetic resonance and M-mode echocardiography

INTRODUCTION: Both echocardiography and CMR imaging are used to quantify longitudinal function. Inter-method variability for mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursion, and variability between directly measured MAPSE and TAPSE and as based on atrio-ventricular plane displacement (AVPD) analysis by CMR, are however not known. This study therefore assessed inter-method variability and variability between annular plane systolic excursion and AVPD-based values in a healthy adult population.

METHODS: Echocardiography and CMR were performed in 111 adults (35 [32 - 38] years). Method comparisons were assessed with Deming regression, Bland-Altman analysis and coefficient of variation. Observer reproducibility was assessed by the concordance correlation coefficient.

RESULTS: Echocardiography and semi-automatic CMR agreed on MAPSE (17±2mm vs. 17±2mm, p=0.1) and TAPSE (25±3mm vs. 25±3mm, p=0.5), correlated highly between methods (fitted-slope 1.22 [95% CI 1.07-1.38] and 1.12 [95% CI 0.95-1.29]) and showed low bias (0.42 [95% CI -2.05-2.88] and -0.18 [95% CI -4.78-4.43]). Intra-/inter-observer reproducibility was high for both methods for both MAPSE (echocardiography 0.96/0.86; CMR 0.87/0.85) and TAPSE (echocardiography 0.96/0.95; CMR 0.97/0.96). MAPSE (16 ± 2 mm vs. 17 ± 2 mm; p<0.001) and TAPSE (24 ± 3 vs. 25 ± 3 mm; p<0.001) based on AVPD were similar but statistically different compared to semi-automatic CMR.

CONCLUSIONS: Echocardiography and semi-automatic CMR have low variability and provide similar values for MAPSE and TAPSE, and are thus interchangeable for follow-up studies. Lateral values based on tracked data from AVPD analysis are not clinically significantly different and could be used as a representation of annular displacement.