Key result
An average E/a´ ratio >10 detected or ruled out grade II-III diastolic dysfunction and elevated left atrial pressure with an AUC of 0.92, 97.6% sensitivity, and 98.2% negative predictive value.
Why the study?
Does the E/a´ ratio accurately detect grade II-III diastolic dysfunction and elevated left atrial pressure in patients with decreased ejection fraction?
Observational (n=113)
Does the E/a´ ratio accurately detect grade II-III diastolic dysfunction and elevated left atrial pressure in patients with decreased ejection fraction?
The E/a´ ratio serves as a highly sensitive and simple screening tool for detecting grade II-III diastolic dysfunction and elevated left atrial pressure in patients with reduced ejection fraction.
E/a´ ratio >10 may aid ruling out advanced diastolic dysfunction in HFrEF; leaves open prospective validation before practice change.
OBJECTIVES: Could a diastolic dysfunction and an increased LV-filling pressure according to ASE/EACVI guidelines be detected or ruled out by the E/a´ratio in patients with decreased ejection fraction. DESIGN: We retrospectively evaluated the diastolic function of 113 unselected in-hospital patients, aged 40-84 years, in sinus rhythm and with no or mild valve disease, having a decreased systolic function (EF ≤50%) using the new ASE/EACVI guidelines and compared these results with the E/a´ratio derived from the E wave in the mitral flow and the a´velocity in the tissue Doppler. RESULTS: The average E/a´ ratio is a strong predictor of a grade II-III diastolic dysfunction and an elevated left atrial pressure according to ASE/EACVI guidelines with an AUC of 0.92. An average E/a´ ratio with a cut-off >10 had a sensitivity of 97.6% and a negative predictive value of 98.2% in detecting or ruling out a grade II-III diastolic dysfunction and an elevated left atrial pressure according to the current guidelines. CONCLUSION: The average E/a´ ratio might be useful as a fast screening tool of a left ventricular dysfunction and an increased left ventricular filling pressure in patients with a decreased ejection fraction.
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Johansson et al. (2017) conducted an observational in Decreased ejection fraction (n=113). E/a´ ratio vs. ASE/EACVI guidelines was evaluated on Grade II-III diastolic dysfunction and an elevated left atrial pressure (AUC 0.92). An average E/a´ ratio >10 detected or ruled out grade II-III diastolic dysfunction and elevated left atrial pressure with an AUC of 0.92, 97.6% sensitivity, and 98.2% negative predictive value.
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