Use of Intraoperative Transesophageal Echocardiography to Measure Mitral Annular Displacement For Predicting Left...

This study aimed to observe whether transesophageal echocardiography (TEE)-guided measurement of mitral annular displacement (MAD) value predicts left ventricular (LV) systolic function in patients posted for coronary artery bypass grafting (CABG) surgeries. The primary objective was to observe the correlation between MAD and LV ejection fraction (EF) derived by Simpson's biplane method, whereas the secondary objective was to examine the correlation between MAD and global longitudinal strain (GLS) derived by speckle tracking echocardiography.

This was a prospective observational study conducted at a tertiary care level hospital in 46 patients undergoing CABG. TEE-guided measurements of MAD, EF, and GLS were obtained after induction of anesthesia but prior to the surgical incision.

The Pearson correlation coefficient test and independent t-tests were used for the analysis. The correlation coefficients (95% CI) of the average value of EF with the septal MAD was 0.67 (0.477-0.807), with the lateral MAD was 0.63 (0.418-0.779), and that with the average MAD was 0.68 (0.487-0.811). The correlation coefficients (95% CI) of the average GLS with the septal MAD was 0.74 (0.577-0.850), with the lateral MAD was 0.79 (0.643-0.877), and that with the average MAD was 0.80 (0.658-0.883). All values were statistically significant (P < 0.001). The mean MAD (in mm) calculated in patients with EF <=40% was -5.38 ± 1.54, and that in patients with EF >40% was -7.17 ± 1.88 (P < 0.001).

TEE-guided MAD could serve as a dependable estimate of LV systolic function. However, larger trials with a greater sample size are needed for a more conclusive assessment.