MAPSE & TAPSE or
mitral annular plane systolic excursion
and tricuspid annular plane systolic excursion
as we know during systole the long axis becomes short so
long axis shortening happens in during systolic. in another world the
base of the heart during systole move forward toward the apex. that is we
called it excursion. if we measure this amount of the displacement of the base
of the heart toward the apex indirectly we can have a good indicator for left
ventricular a right ventricle systolic function. this type of the measurement is
valuable only if the patient doesn't have prominent valvular classification
or no heart surgery. let's go first with the TAPSE.
For TAPSE we have to get a good four chamber view and put cursor to the
lateral annulus of tricuspid valve. here as you see. and then do m- mode.
the important point for this type of study is that you put the cursor the way that is
parallel to the movement annulus. if you notice here. the cursor line is this
way. I put it at lateral annulus of tricuspid and annulus moves almost,
almost parallel but not exactly. if it's not parallel completely go a little off-
axis and try find an image that give you that option. so if
you found that I'm a little off-axis here but here in this way I am
completely almost parallel to the lateral tricuspid annulus plane and then
I hit the m-mode and I will get such image very nice.
for measuring TAPSE we just I have to find exactly how much that part of the cursor
that crossed tricuspid lateral plane how much goes forward, is very easy if you
measure that is the lowest spot that had and then I go and find how much it goes
higher so one here
here and another one, if you use Cal is much better. I can measure put it here
and automatically machine show me here 2.3 or I can I have it this horizontal
line exactly the maximum point is here so I can do the same way here or no this
way. this height (represnets) this amount of going down and up this distance gives me
excursion- how much that spot of annulus tricuspid valve moves forward.
almost two point three (2.3). so this is my TAPSE. Normal TAPSE is
equal or more than 18 millimeter. if it's below the 15 is almost indicates we have
some kind of right ventricular systolic function problem.
for the MAPSE we have
two actually- three spots for doing for MAPSE. medial, lateral and anterior annulus.
for that matter we go four chamber (view) find a nice four chamber
and then do it first for the medial annulus put cursor at the exactly
medial annulus and then hit the m-mode and you will see this image and you then
measure the amount of excursion that in this case-if I measure it - is from here
the minimum the lowest part to the
highest part, here as you see here.
and then both of them will be correct just as long as you measure it exactly
how much that spot goes forward to the apex here there you go
and for lateral you do -put the cursor on lateral wall - at annulus-and try to
get it parallel to the movement of the annulus here, as you see lateral and then
hit the m-mode and then repeat it and measure the same for how much it goes up
from that point. normal for the this measurement is 12 to 15 mm
even the medial annulus excursion is less than 8 usually it represents
systolic ejection fraction less than 50% and for the anterior annulus excursion
you can go for apical two chamber and put the anterior annulus on the
mitral valve and then hit the m-mode and you get it that one too