Key result
E/A ratio shows no association with cardiovascular hospitalization or death.
Why the study?
Diastolic dysfunction is linked to HFpEF and higher mortality, making early identification essential to potentially alter disease course.
Does the E/A ratio predict hospitalization for cardiovascular causes and death in a primary care population?
Observational (n=560)
No
Does the E/A ratio predict hospitalization for cardiovascular causes and death in a primary care population?
Answers are grounded in this paper and cite their sources.
The E/A ratio showed an altered pattern in the majority of primary care participants without diagnosed heart failure, potentially characterizing subclinical stage B HF, though adjusted HRs for hospitalization and death were not statistically significant.
Introduction: Diastolic dysfunction (DD) has a significant impact on the non-hospitalized population and is associated with heart failure with preserved ejection fraction (HFpEF) and higher mortality. Early diagnosis is crucial and echocardiography, due to its accessibility and correlation with invasive data, is essential. Among the parameters assessed, the E/A ratio stands out for reflecting diastolic function and is fundamental in the early identification of alterations that can modify the course of the disease, reducing individual and collective impacts. Aim: To assess the potential of the ratio between initial mitral flow velocity and end-diastolic mitral flow velocity (E/A) as a prognostic factor for hospitalization for cardiovascular causes and deaths in primary health care. Method: A community-based longitudinal observational ecological study was carried out, recruiting 633 individuals for clinical evaluation and echocardiography with tissue Doppler and pulsed Doppler spectral analysis to measure the velocity of the E/A ratio, with two different cut-off points for characterizing DD. Results: After six years, 560 participants completed the study to investigate the causes of hospitalization and death. Survival and hazard ratio analyses were carried out. Multivariate Cox regression with Schoenfeld residual analysis in the univariate analysis, and a final model were created. 355 (63%) were women aged around 59. 405 participants (72.3%) were diagnosed with hypertension, 133 (23.8%) were diagnosed with diabetes and 99 (17.7%) were current smokers. A crude HR of 3.47 and 3.60 and 3.02 and 0.41 was identified for DD class II and III at cut-off points 1 and 2 respectively (p<0.01). After adjusting for gender and age, the HR was 1.69, 2.80 and 1.53 and 0.49 for DD class II and III at cut-off points 1 and 2 respectively (p>0.1). Conclusion: The E/A ratio showed an altered pattern in the majority of study participants who were not diagnosed with heart failure, which may characterize its subclinical form, stage B HF.
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Leite et al. (2025) conducted an observational in Diastolic dysfunction (n=560). E/A ratio assessment vs. Normal E/A ratio was evaluated on Hospital admission for cardiovascular causes or death from any cause (HR 1.69, p=>0.1). The E/A ratio was not significantly associated with the composite outcome of cardiovascular hospitalization or death after adjusting for age and sex (adjusted HR 1.69 for DD class II, p>0.1).
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