The mitral E/Ea ratio derived from Doppler tissue imaging correlated strongly with invasive pulmonary capillary wedge pressure (r = 0.87), allowing noninvasive estimation of LV filling pressures.
Cross-Sectional (n=125)
Does the E/Ea ratio derived from Doppler tissue imaging accurately estimate left ventricular filling pressures?
The E/Ea ratio derived from Doppler tissue imaging is a reliable, noninvasive index for estimating left ventricular filling pressures.
Effect estimate: r = 0.87
OBJECTIVES: This investigation was designed 1) to assess whether the early diastolic velocity of the mitral annulus (Ea) obtained with Doppler tissue imaging (DTI) behaves as a preload-independent index of left ventricular (LV) relaxation; and 2) to evaluate the relation of the mitral E/Ea ratio to LV filling pressures. BACKGROUND: Recent observations suggest that Ea is an index of LV relaxation that is less influenced by LV filling pressures. METHODS: One hundred twenty-five study subjects were classified into three groups according to mitral E/A ratio, LV ejection fraction (LVEF) and clinical symptoms: 34 asymptomatic subjects with a normal LVEF and an E/A ratio > or =1; 40 with a normal LVEF, an E/A ratio 1 (pseudonormal PN). Ea was derived from the lateral border of the annulus. A subset of 60 patients had invasive measurement of pulmonary capillary wedge pressure (PCWP) simultaneous with Doppler echocardiographic DTI. RESULTS: Ea was reduced in the IR and PN groups compared with the group of normal subjects: 5.8 +/- 1.5 and 5.2 +/- 1.4 vs. 12 +/- 2.8 cm/s, respectively (p < 0.001). Mean PCWP (20 +/- 8 mm Hg) related weakly to mitral E (r = 0.68) but not to Ea. The E/Ea ratio related well to PCWP (r = 0.87; PCWP = 1.24 E/Ea + 1.9), with a difference between Doppler and catheter measurements of 0.1 +/- 3.8 mm Hg. CONCLUSIONS: Ea behaves as a preload-independent index of LV relaxation. Mitral E velocity, corrected for the influence of relaxation (i.e., the E/Ea ratio), relates well to mean PCWP and may be used to estimate LV filling pressures.
Nagueh et al. (1997) conducted a cross-sectional in Left ventricular diastolic dysfunction (n=125). Doppler tissue imaging (E/Ea ratio) vs. Invasive pulmonary capillary wedge pressure (PCWP) was evaluated on Correlation between E/Ea ratio and PCWP (r = 0.87). The mitral E/Ea ratio derived from Doppler tissue imaging correlated strongly with invasive pulmonary capillary wedge pressure (r = 0.87), allowing noninvasive estimation of LV filling pressures.