The ratio of early-diastolic inflow velocity to peak longitudinal strain (E/LS) correlated strongly with left ventricular mean diastolic pressure (r=0.70) and was more accurate than E/e' for estimating LV filling pressure.
Observational (n=77)
Yes
Do STE-derived parameters correlate better with LV relaxation and filling pressure than tissue Doppler-derived parameters in patients undergoing hemodynamic evaluation?
STE-derived longitudinal parameters, particularly E/LS, may be more accurate than traditional tissue Doppler E/e' for estimating left ventricular filling pressure.
Effect estimate: r=0.70
Absolute Event Rate: 0.7% vs 0.5%
p-value: p=<0.001
BACKGROUND: Speckle-tracking echocardiography (STE)-derived parameters may have better correlation with left ventricular (LV) relaxation and filling pressure than tissue Doppler-derived parameters. However, it has not been elucidated which parameter - strain or strain rate - and which direction of myocardial deformation - longitudinal or circumferential - is the most useful marker of LV relaxation and filling pressure. METHODS AND RESULTS: We conducted a prospective multicenter study and compared the correlation of tissue Doppler- and STE-derived parameters with the time constant of LV pressure decay (τ) and LV mean diastolic pressure (MDP) in 77 patients. The correlation of early-diastolic mitral annular velocity (e´) with τ was weak (r=-0.32, P<0.01), and that of peak longitudinal strain (LS) was the strongest (r=-0.45, P<0.001) among the STE-derived parameters. There was a modest correlation between LVMDP and the ratio of early-diastolic inflow velocity (E) to e´ (E/e´) (r=0.50, P<0.001). In contrast, the ratio of E to LS (E/LS) correlated strongly with LVMDP (r=0.70, P<0.001). The correlation of E/LS with LVMDP was significantly better than that for E/e´ (P<0.01). Receiver-operating characteristic analysis showed that E/LS had the largest area under the curve for distinguishing elevated LVMDP (E/LS 0.86, E/e´ 0.74, E/A 0.67). CONCLUSIONS: STE-derived longitudinal parameters correlated well with LV relaxation and filling pressure. In particular, E/LS could be more accurate than E/e´ for estimating LV filling pressure. (Circ J 2016; 80: 1163-1170).
Hayashi et al. (Fri,) conducted a observational in Cardiac diseases (angina pectoris, prior MI, DCM, HCM, hypertensive heart disease) (n=77). Speckle-tracking echocardiography (STE)-derived parameters (E/LS) vs. Tissue Doppler-derived parameters (E/e') was evaluated on Correlation with left ventricular mean diastolic pressure (LVMDP) (r=0.70, p=<0.001). The ratio of early-diastolic inflow velocity to peak longitudinal strain (E/LS) correlated strongly with left ventricular mean diastolic pressure (r=0.70) and was more accurate than E/e' for estimating LV filling pressure.