Echocardiographic tissue Doppler assessment (E/e') was not useful for assessing left ventricular filling pressure changes in 7 of 9 studies (N=429) of patients with preserved LVEF.
Systematic Review
Does echocardiographic E/e′ accurately reflect invasive left ventricular filling pressure changes after exercise or pharmacological intervention?
There is insufficient evidence to support the use of E/e′ for reliably assessing LVFP changes in response to exercise or other interventions.
Background Noninvasive echocardiographic tissue Doppler assessment (E/e′) in response to exercise or pharmacological intervention has been proposed as a useful parameter to assess left ventricular ( LV ) filling pressure ( LVFP ) and LV diastolic dysfunction. However, the evidence for it is not well summarized. Methods and Results Clinical studies that evaluated invasive LVFP changes in response to exercise/other interventions and echocardiographic E/e′ were identified from PubMed, Scopus, Embase, and Cochrane Library databases. We grouped and evaluated studies that included patients with preserved LV ejection fraction ( LVEF ), patients with mixed/reduced LVEF , and patients with specific cardiac conditions. Overall, we found 28 studies with 9 studies for preserved LVEF , which was our primary interest. Studies had differing methodologies with limited data sets, which precluded quantitative meta‐analysis. We therefore descriptively summarized our findings. Only 2 small studies (N=12 and 10) directly or indirectly support use of E/e′ for assessing LVFP changes in preserved LVEF . In 7 other studies (cumulative N=429) of preserved LVEF , E/e′ was not useful for assessing LVFP changes. For mixed/reduced LVEF groups or specific cardiac conditions, results similar to preserved LVEF were found. Conclusions We find that there is insufficient evidence that E/e′ can reliably assess LVFP changes in response to exercise or other interventions. We suggest that well‐designed prospective studies should be conducted for further evaluation.
Sharifov et al. (Wed,) conducted a systematic review in Left ventricular diastolic dysfunction. Echocardiographic tissue Doppler assessment (E/e') vs. Invasive left ventricular filling pressure measurement was evaluated on Reliability of E/e' to assess left ventricular filling pressure changes. Echocardiographic tissue Doppler assessment (E/e') was not useful for assessing left ventricular filling pressure changes in 7 of 9 studies (N=429) of patients with preserved LVEF.