Jinyang Yu Profile picture
Research: Automatic #TEE for hemodynamic monitoring by #AutoMAPSE #MAPSE #POCUS #CardioTwitter Interests: Stoisicm, meditation, deliberate practice.

Jan 31, 10 tweets

🚨Automatic measurement of LV function in #ICU is possible by automatic measurement of #MAPSE using TEE and AI #AutoMAPSE
🔓

1/🧵Still, many prefer EF for LV function. How does MAPSE compare to EF, and is MAPSE better?
#EchoFirst #POCUS #FOAMed rdcu.be/dxsEU

2/ #MAPSE and EF are highly correlated. EF reflects SV/EDV, while MAPSE reflect SV/outer cross-sectional area.

Appreciate their relationship in this figure⬇️ doi.org/10.1152/ajphea…

3/ In heart failure with⬇️EF, the LV dilates, and both EF and #MAPSE falls from increases EDV and outer cross-sectional area.

The figure shows that both EF and MAPSE falls during LV dilatation. #CardioTwitter

4/ In heart failure with preserved EF, LV dysfunction from concentric remodeling reduces #MAPSE. Since EDV is maintained or even reduced, EF is unaffected.

The figure shows that MAPSE is reduced, but EF is maintained when EDV is reduced. #CardioTwitter

5/ #MAPSE is reduced for both HFpEF and HFrEF. This was shown many years ago:
This relationship may also explain that MAPSE show superiority in #ICU: doi.org/10.1136/heart.…
doi.org/10.1186/1476-7…

6/ In #ICU, EDV is commonly reduced from vasodilatation and hypovolemia. In this setting, EF is usually normal or even increased if ⬇️MAP. Despite a "hyperdynamic EF", hypovolemia decreases #MAPSE.

The figure shows reduced MAPSE and high EF during hypovolemia. #FOAMcc

7/ SV is normal or increased during vasodilatation. This would tend to increase #MAPSE. Perhaps normal MAPSE in shock could aid the diagnosis of vasodilatation.

The figure shows how normal MAPSE during shock suggests vasodilatation. However, patient data is lacking.

8/ EF by Simpson's is often unfeasible in #ICU, while #MAPSE is highly feasible. Thus, EF is usually qualitative, while MAPSE is quantitative, and quantitative data always offers more information and is necessary for true monitoring.

9/ #MAPSE is an underappreciated hero. #MAPSE measures LV longitudinal function (like GLS), and has shown better sensitivity than EF for detecting LV dysfunction.
...and #MAPSE can now be assessed automatically in #ICU😎📜

rdcu.be/dxsEU

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