Discover and read the best of Twitter Threads about #MAPSE
Most recents (4)
MAPSE in #IntensiveCare (with examples)🧵#FOAMcc #FOAMed #MedTwitter #Hemodynamic #POCUS #EchoFirst #CriticalCare
Take homes:
1⃣ Redefining "the hyperdynamic heart" with #MAPSE
2⃣ MAPSE is better than EF in the #ICU
3⃣ Linking MAPSE with supply/demand-ischemia
1/n
Take homes:
1⃣ Redefining "the hyperdynamic heart" with #MAPSE
2⃣ MAPSE is better than EF in the #ICU
3⃣ Linking MAPSE with supply/demand-ischemia
1/n
1⃣ Can MAPSE redefine "the hyperdynamic heart?
The term "hyperdynamic LV" - EF > 55% - is misleading. It has no relation to a hyperdyanmic circulation; SV/CO. Someone bleeding to death has a hyperdynamic heart, but the circulation is life-threatening hypodynamic.
2/n
The term "hyperdynamic LV" - EF > 55% - is misleading. It has no relation to a hyperdyanmic circulation; SV/CO. Someone bleeding to death has a hyperdynamic heart, but the circulation is life-threatening hypodynamic.
2/n
MAPSE is cardiac motion, and defining the hyperDYNAMIC heart as good cardiac motion makes perfect sense. Recent geometrical analysis of cardiac pumping shows that MAPSE is the main determinant of SV. Fig from @mugander: tinyurl.com/mxbfmcyk
Why?
3/n
Why?
3/n
A case of low ScvO2 (60%), high PvaCO2 (8.2 mmHg), fluid intolerance (CVP 11) and fluid responsiveness (PPV 17). What's the physiology and what to do?
#FOAMcc #Hemodynamics #ThePeoplesVentricle #FOAMed #Fluidtolerance #Cardiotwitter #CriticalCare
#FOAMcc #Hemodynamics #ThePeoplesVentricle #FOAMed #Fluidtolerance #Cardiotwitter #CriticalCare
Post-cardiac surgery. MAP 70, HR 95, low dose pressor. High CVP (11 mmHg) with pathologic waveform of x < y-descent. PPV > 17 despite low Vt (< 6 mL/kg). Normal blood gasses, normal lactate.
Do you routinely measure #MAPSE?
Did you know that MAPSE beats #GLS and #LVEF regarding prognosis?
A new multicenter collab study out, led by @KellmanPeter
Ref:
#WhyCMR 🫀🧲 #EchoFirst 🫀🔊
A thread 🧵. 1/n pubmed.gov/35132872
Did you know that MAPSE beats #GLS and #LVEF regarding prognosis?
A new multicenter collab study out, led by @KellmanPeter
Ref:
#WhyCMR 🫀🧲 #EchoFirst 🫀🔊
A thread 🧵. 1/n pubmed.gov/35132872
We know that GLS is a composite measure correlated w LVEF, LVEDV, LVESV, LV mass, infarction, non-ischemic scar, aortic stenosis, mitral regurg, ECV.
So, not surprisingly, GLS associates with poor prognosis.
Ref: Suppl Table 2
2/n pubmed.gov/32563637
So, not surprisingly, GLS associates with poor prognosis.
Ref: Suppl Table 2
2/n pubmed.gov/32563637
Notably, mitral annular plane systolic excursion #MAPSE has been measurable by #EchoFirst since 1986 by M-mode ().
3/n pubmed.gov/3464160
3/n pubmed.gov/3464160
Thread: For #POCUS I'd like to say a word about #MAPSE . It's the quickest assessment of global LV function you can do. It is not necessary to do real time M-mode, a simple 4-chamber view will do. Why?
2/ Basically, M-mode can be done by reconstruction after acquisition, or even by caliper measurement on the loop. Frame rate matters very little, as the Mitral plane motion moves slowest at end diastole and end ejection.
3/ Motion of the different parts of the mitral plane is different, so more than one plane site needs to be measured. In a study of 1266 normal subjects (the #HUNT study), mean MAPSE was 1.56 cm for 2 walls (from 4Ch), 1.58 cm for 4 (from 4ch and 2ch) and 1.51 cm for 6 (from all 3
