Assessment of Left Ventricular Function using Mitral Annular Plane Systolic Excursion and its Validation with Conventional Methods and Global Longitudinal Strain using Echocardiography in Patients with Coronary Artery Disease

Objectives The evaluation of left ventricular (LV) function is crucial in assessing myocardial health, with LV ejection fraction (LVEF) serving as a key metric. For LVEF measurement, two-dimensional echocardiography is frequently used, usually with a modified Simpson’s approach. Alternative methods, such as mitral annular plane systolic excursion (MAPSE) and global longitudinal strain (GLS), provide more information about cardiac function, particularly in difficult clinical situations. This study compares MAPSE and GLS with conventional methods in an effort to determine the efficacy of these measures for assessing LVEF in individuals with coronary artery disease (CAD). Materials and Methods The Government General Hospital in Guntur, Andhra Pradesh’s Department of Cardiology conducted this observational and prospective study. There were 300 patients in total, 200 of whom had CAD and 100 of whom were healthy controls. The modified Simpson’s technique had been employed to measure the LVEF, while GLS and MAPSE were used for comparison. Results According to baseline characteristics, there are 300 patients in total, including healthy controls and cases with ejection fraction (EF) < 50% and EF > 50%. For patients with EF < 50%, the mean EF as determined by the modified Simpson’s formula was 37.79 ± 5.38, the mean EF as determined by the MAPSE was 37.95 ± 5.32, and the mean EF as determined by the GLS was 38.74 ± 5.42. Using the GLS, MAPSE, or Simpson’s methods to calculate EF did not vary statistically. The mean EF in patients with EF > 50% was 52.31 ± 4.26 using the MAPSE method and 56.24 ± 3.12 using the Simpson method. In individuals with an EF > 50%, there was a statistically significant variation in the EF computation by both of these methods ( P < 0.0001). The Simpson approach yielded a mean EF of 56.24 ± 3.12, whereas the GLS method yielded a mean EF of 52.82 ± 4.21. In patients with EF > 50%, there was a statistically significant difference in the EF computation by both of these methods ( P < 0.0001). The mean EF estimated using the MAPSE approach was 52.31 ± 4.26, whereas the one using the GLS method was 52.82 ± 4.21. The EF computation revealed no statistically significant variation. Conclusion Modified Simpson’s method correlates well with EF calculations using GLS and MAPSE, particularly in healthy individuals and those with EF < 50%. Nevertheless, differences were noted in patients with CAD and EF > 50%. In this subgroup, there was an association between MAPSE and GLS. Integrating GLS and MAPSE alongside traditional methods can enhance cardiac systolic function assessment, particularly in patients with CAD.