Diagnostic and Prognostic Utility of Mitral Annular Plane Systolic Excursion: A Systematic Review and Meta‐Analysis
TL;DR
Overall, MAPSE has a clinically important role meriting integration into routine cardiac imaging and care, and demonstrated strong prognostic value, outperforming LVEF and global longitudinal strain in predicting adverse events in several studies.
Abstract
Background Movement of the mitral annulus toward the left ventricular (LV) apex during systole, termed atrioventricular plane displacement or mitral annular plane systolic excursion (MAPSE), was first observed by Leonardo da Vinci in the 15th century. MAPSE, a measure of longitudinal movement, shows good agreement between transthoracic echocardiography and cardiovascular magnetic resonance imaging and can also be measured by transesophageal echocardiography and cardiac computed tomography. Measurement is fast, simple, and easily automated. However, no major imaging guidelines advise routine measurement. Methods We present a systematic review of studies appraising the diagnostic and prognostic performance of MAPSE from PubMed, Medline, Google Scholar, and Embase until September 2025 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Studies assessing MAPSE in adult populations were included, and non‐English publications, abstracts, and studies of congenital heart disease were excluded. Newcastle–Ottawa Scale assessed study quality. Correlation coefficients between MAPSE and markers of systolic function were pooled using Hunter–Schmidt meta‐analysis. Heterogeneous diagnostic and prognostic outcomes were synthesized narratively. Results The review included 92 studies. MAPSE correlated with LV ejection fraction (r=0.64 [95% CI, 0.54–0.74]) and global longitudinal strain (r=0.53 [95% CI, 0.45–0.63]), showing a modest association with systolic function, particularly useful in patients with poor echocardiographic windows. MAPSE was frequently reduced despite preserved LV ejection fraction across multiple pathologies, enabling earlier detection of systolic impairment. MAPSE also demonstrated strong prognostic value, outperforming LVEF and global longitudinal strain in predicting adverse events in several studies. Conclusions Overall, MAPSE has a clinically important role meriting integration into routine cardiac imaging and care.