E-point septal separation (EPSS) is a rapid, M-mode echocardiography technique to estimate LVEF). It measures the distance between the mitral valve’s anterior leaflet and the septum during diastole.
EPSS Interpretation (Adults):
- <7 mm: Normal Systolic Function (LVEF >50-55%).
- 8-18 mm: Mildly to Moderately Reduced EF.
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13-18 mm: Suggestive of Severely Reduced EF (<30-35%).
How to Measure EPSS:
- View: Obtain a Parasternal Long Axis (PLAX) view, zooming in on the mitral valve.
- M-Mode: Place the M-mode cursor over the tip of the anterior mitral valve leaflet.
- Measurement: Measure the minimum distance between the E-point (max opening) and the septum.
Key Limitations & Tips:
False Increases: EPSS may be misleading in mitral stenosis, aortic regurgitation, or left ventricular hypertrophy.
Validation: Use EPSS to confirm visual estimations of cardiac function, rather than relying on it exclusively.
Clinical Goal: The primary purpose is to distinguish between normal and reduced LVEF quickly at the bedside.