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  • Title: [Significance of the E point-septum distance for the evaluation of left ventricular function in coronary disease--a study using M-mode echocardiography].
    Author: Koenig W, Gehring J, Kollmann G, Schinz A, Beckmann R, Mathes P.
    Journal: Z Kardiol; 1983 Nov; 72(11):649-56. PubMed ID: 6659642.
    Abstract:
    In 121 patients (pts) with angiographically proven coronary artery disease, left ventricular (LV) cineangiograms were quantitatively evaluated. 79 pts showed regional wall abnormalities. In this group the relationship between echocardiographic parameters of global (LV) function (mitral-septal separation, systolic and diastolic diameter, and fractional shortening) and ventriculographic parameters was investigated. Mitral-septal separation showed the best correlation to the angiographic ejection fraction (EF) (r = -0.72). The measurement of this parameter allows the diagnosis of a reduced EF independently of the dilatation of the left ventricle, and is easy to perform and to reproduce. Mitral-septal separation discriminated well between the reference group and all infarction subgroups (posterior wall, anterior wall, and double infarction) with reduced EF. The modification of the mitral-septal separation measurement according to D'Cruz et al. showed no advantage over that proposed by Massie et al. Both are clearly dependent upon septal excursion, which has to be taken into consideration when mitral-septal separation is being evaluated. The sensitivity of mitral-septal separation (greater than 7 mm) for the detection of reduced LV function (less than 55%) was 0.66; the specificity was 0.80. There was greater sensitivity for anterior wall infarctions than for posterior wall infarctions (0.73 vs 0.44). Because of the relatively high number of false negatives, only a pathologic mitral-septal separation is diagnostically useful.
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