Key result
Evaluating E/e' > 14 identifies ~74% of diastolic dysfunction cases, outperforming E/A ratio alone.
Why the study?
Reporting diastolic dysfunction solely by mitral flow E/A ratio risks missing patients with pseudo-normalization, highlighting the need to evaluate additional parameters.
Cross-Sectional (n=1,982)
No
Absolute Event Rate: 74.2% vs 35.4%
Comprehensive echocardiographic assessment using 2016 ASE/EACVI criteria is necessary to accurately diagnose diastolic dysfunction, as relying solely on the E/A ratio misses many cases.
May support comprehensive diastolic assessment in practice; leaves open prospective validation of diagnostic thresholds.
IntroductionDiastolic dysfunction (DD) is understood as impaired Left ventricular relaxation. Echocardiography is the key in diagnosis. In 2016 recommendation by American Society of Echocardiography(ASE) and the European Association of Cardiovascular Imaging (EACVI) was updated. In our country we do not have a general consensus. Diastolic dysfunction is reported on the basis of E/A ratio of mitral flow, that has the chance of missing a lot of patients with pseudo-normalization. This study carried out to look at importance of evaluation of other parameters to diagnose a patient with diastolic dysfunction.Methods: It is a retrospective cross-sectional descriptive study. Echocardiography report from the year 2018 and 2019 was collected from database and the patients with diagnosis of Diastolic dysfunction were selected. Patient profile and the echocardiographic parameter were recorded. Echocardiography was reported according to 2016 ASE and EACVI update.Results: Total of 1982 patients selected for analysis. E/A < 0.8 was seen in 702(35.4%) patients, E/A 0.8- 2.0 was seen in 1136 (57.3%) patients and E/A > 2.0 was found in 144(7.3%) patients. The most common finding being E/e’ 1470 (74.2%) of patients followed by TR velocity > 2.8m/s 1422 (71.7%), Septal e’ velocity < 7 cm/s or Lateral e’ velocity <10 cm/s 1334 (67.3%) and LA area >20 cm2 1286 (64.8%) respectively.Conclusions: Diastolic dysfunction should be evaluated using all the parameters recommended by 2016 ASE andEACVI guideline update. Measurement of only E/A ratio has a chance of missing large number of patient with DD.
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Humagain et al. (2023) conducted a cross-sectional in Diastolic dysfunction (n=1,982). Echocardiographic assessment using 2016 ASE/EACVI guidelines vs. E/A ratio alone was evaluated on Prevalence of echocardiographic parameters for diastolic dysfunction. Among 1,982 patients with diastolic dysfunction, relying solely on an E/A ratio < 0.8 identified only 35.4% of cases, whereas evaluating E/e' > 14 identified 74.2%, highlighting the need for comprehensive assessment.
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