Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart:: Insights from M-mode analysis of annular motion

Background: Extensive data exist regarding annular descent and ventricular function. We have already demonstrated significant differences in amplitude and timing of events between maximal mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursion as well as described quantitative temporal differences in annular ascent (AA) between the right and left sides of the heart. However, whether any relationship exists between annular ascent and descent components remains uninvestigated. Methods: Left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), MAPSE, TAPSE, MV, and TV AA as well as pulsed tissue Doppler of the lateral MV and TV annuli were recorded from 53 patients. Results: In this population (age 55 +/- 17 years) mean LVEF was 55 +/- 19%, mean RVFAC was 47 +/- 20%, mean MAPSE was 2.11 +/- 0.72 cm, mean TAPSE was 1.48 +/- 0.44 cm, mean MV AA was 0.52 +/- 0.17 cm, TV AA was 0.96 +/- 0.47, MV A-wave 0.10 +/- 0.04 cm/s, and TV A-wave was 0.13 +/- 0.05 cm/s. A more robust correlation was seen between TV AA and RVFAC than between MV AA and LVEF and also between TV AA and pulsed TDI TV A-wave velocity than between MV AA and pulsed TDI MV A-wave. Conclusion: Our data reveal that mechanical systolic functions of the atria and the ventricles are more closely coupled on the right than on the left side of the heart. Whether this is a result of anatomic linking or chamber geometry will require further study.