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June 2, 1997European Heart JournalOpen Access

The prevalence of left ventricular diastolic filling abnormalities in patients with suspected heart failure

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Why the study?

Does the E/A ratio effectively detect left ventricular diastolic filling abnormalities in an unselected group of patients with suspected heart failure?

Population

n=534 patients referred by general practitioners to an open-access echocardiography service for assessment…

Comparison

Echocardiography including a Doppler study of… vs Age-adjusted reference ranges.

Design

Cross-sectional

Authors

ADA. P. DavieNHS FifeCFC. M. FrancisThe Royal Melbourne HospitalLCL. CaruanaPrince Charles Hospital

Discussion

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Implication

E/A abnormalities uncommon in suspected HF with preserved systolic function; leaves open its diagnostic value versus true low prevalence of diastolic issues.

Key Points

  • This study aims to determine how common left ventricular diastolic filling abnormalities are in patients with suspected heart failure.
  • Patients were referred for echocardiography to assess possible heart failure.
  • Doppler study of transmitral flow was performed to calculate the E/A ratio.
  • A total of 534 patients were assessed, focusing on those with normal systolic function.
  • Of the 371 patients with normal systolic function and measurable E/A ratios, 9 had values above the reference range and 19 below.
  • 96 cases of left ventricular systolic dysfunction were found in the overall group, with 52 among those with measurable E/A ratios.
  • The findings suggest left ventricular diastolic abnormalities are much less common than previously believed.

Structured PICO

Does the E/A ratio effectively detect left ventricular diastolic filling abnormalities in an unselected group of patients with suspected heart failure?

P
Population
n=534 patients referred by general practitioners to an open-access echocardiography service for assessment of possible heart failure.
I
Intervention
Echocardiography including a Doppler study of transmitral flow at the tips of the mitral leaflets and calculation of an E/A ratio.
C
Comparator
Age-adjusted reference ranges.
O
Outcome
Prevalence of left ventricular diastolic filling abnormalities (E/A ratio above or below age-adjusted reference ranges).surrogate

The study suggests that either left ventricular diastolic filling abnormalities are much less common than previously supposed, or the E/A ratio is an ineffective tool for their detection in unselected patients.

Cite This Study

Davie et al. (1997) studied this question.

synapsesocial.com/papers/69ff959f2ff633f3657799b4https://doi.org/10.1093/oxfordjournals.eurheartj.a015387

Topics

HFrEF treatmentHeart failure
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Doppler-Echocardiographic Indices of Diastolic Function in Heart Failure Admissions with Preserved Left Ventricular Systolic Function2002 · 37 citations
  2. 2The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern2017 · 3 citations
  3. 3Left ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: time for a redefinition?2002 · 341 citations
  4. 4The prevalence of impaired left ventricular diastolic filling is related to the extent of coronary atherosclerosis in patients with stable coronary artery disease2002 · 17 citations
  5. 5"Diastolic heart failure" or heart failure caused by subtle left ventricular systolic dysfunction?2002 · 162 citations