Pediatric Cardiology

, Volume 36, Issue 1, pp 20–26 | Cite as

Longitudinal Systolic Left Ventricular Function in Preterm and Term Neonates: Reference Values of the Mitral Annular Plane Systolic Excursion (MAPSE) and Calculation of z-Scores

  • Martin KoestenbergerEmail author
  • Bert Nagel
  • William Ravekes
  • Andreas Gamillscheg
  • Corinna Binder
  • Alexander Avian
  • Jasmin Pansy
  • Gerhard Cvirn
  • Berndt Urlesberger
Original Article


The mitral annular plane systolic excursion (MAPSE) is a quick and reliable echocardiographic tool for assessing longitudinal left ventricular (LV) systolic function in children and adults. Because this parameter is affected by the LV longitudinal dimension, pediatric and adult normal values are not suitable for preterm and term neonates. A prospective study investigated a large group of preterm and term neonates [gestational age (GA), 26/0–6 to 40/0–6; birth weight (BW), 670–4,140 g]. The growth- and BW-related changes in MAPSE were determined to establish normal z-score values for preterm and term neonates. The MAPSE ranged from a mean of 0.36 ± 0.05 cm in preterm neonates with a GA of 26/0–6 to 0.56 ± 0.08 cm in term neonates with a GA of 40/0–6. The findings showed MAPSE, GA, and BW to be moderately correlated. Pearson’s correlation coefficient was 0.56 for GA (MAPSE; p < 0.001) and 0.58 for BW (MAPSE; p < 0.001). The normal MAPSE values did not differ significantly between females and males (p = 0.946). The absolute values and z-scores of normal MAPSE values in healthy preterm and term neonates within the first 48 h of life were calculated, and percentile charts were established. Determination of LV function using MAPSE might be useful for vulnerable infants for whom a prolonged examination is inappropriate and for neonates with suboptimal visualization of the endocardium.


Mitral annular plane systolic excursion Left ventricular long-axis function Preterm Neonates Reference values Birth weight M-mode z-Score 


Conflict of interest

All authors state that there are no financial, personal or other relationships with other people or organizations that could inappropriately influence our work to disclose.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Martin Koestenberger
    • 1
    Email author
  • Bert Nagel
    • 1
  • William Ravekes
    • 2
  • Andreas Gamillscheg
    • 1
  • Corinna Binder
    • 3
  • Alexander Avian
    • 4
  • Jasmin Pansy
    • 3
  • Gerhard Cvirn
    • 5
  • Berndt Urlesberger
    • 3
  1. 1.Division of Pediatric Cardiology, Department of PediatricsMedical University GrazGrazAustria
  2. 2.Division of Pediatric CardiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Division of Neonatology, Department of PediatricsMedical University GrazGrazAustria
  4. 4.Institute for Medical Informatics, Statistics and DocumentationMedical University GrazGrazAustria
  5. 5.Institute of Physiological Chemistry, Center of Physiological MedicineMedical University GrazGrazAustria

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