Related Experiment Video
Updated: May 7, 2026
Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
The prognostic value of a new tissue Doppler parameter in patients with heart failure
Cristian Mornoş1, Lucian Petrescu, Adina Ionac
1Cardiology Clinic, "Victor Babeş" University of Medicine and Pharmacy, G.Adam 13A, Timişoara, Romania.
Insights
A new heart failure index, E/(E' × S') > 1.6, accurately predicts poor outcomes. This tissue Doppler index is a powerful predictor of cardiac events and hospital readmissions in heart failure patients.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- The tissue Doppler index E/(E' × S') shows accuracy in predicting elevated left ventricular end-diastolic pressure.
- Heart failure (HF) management requires reliable prognostic indicators for clinical decision-making.
Purpose of the Study:
- To evaluate the prognostic value of the tissue Doppler index E/(E' × S') > 1.6 in hospitalized heart failure patients.
- To determine if this index predicts long-term cardiac death or HF readmission.
Main Methods:
- Echocardiography was performed on 345 HF patients at discharge and 1 month later.
- Patients were categorized based on E/(E' × S') values at discharge (≤1.6 or >1.6).
- Long-term follow-up assessed cardiac death and HF readmission rates.
Main Results:
- 55.7% of patients had E/(E' × S') > 1.6 at discharge.
- The composite endpoint of cardiac death or HF readmission was significantly higher in the E/(E' × S') > 1.6 group (84.9% vs. 17.6%).
- E/(E' × S') > 1.6 was the strongest independent predictor of cardiac events (HR=4.46).
Conclusions:
- An E/(E' × S') value > 1.6 at hospital discharge is a powerful predictor of adverse clinical outcomes in heart failure.
- Worsening of this index after 1 month further indicates a poor prognosis.
- This novel index offers valuable prognostic information for heart failure management.
Abstract:
It has been shown a good accuracy to predict high left ventricular end-diastolic pressure for a value >1.6 of a new tissue Doppler index, E/(E' × S'), including the ratio between early diastolic transmitral and mitral annulus velocity (E/E'), and the systolic mitral annulus velocity (S'). Our aim was to evaluate the prognostic value of E/(E' × S') > 1.6 in patients with heart failure (HF). Echocardiography was performed in 345 consecutive hospitalized patients with HF, in sinus rhythm, at hospital discharge and after 1 month. Worsening of E/(E' × S') was defined as any increase of baseline value. The primary end point consisted of cardiac death or readmission due to HF worsening in long term follow-up. At discharge, 153 patients (44.3%) presented E/(E' × S') ≤ 1.6 (group I) while 192 patients (55.7%) presented E/(E' × S') > 1.6 (group II). During the follow-up period (35.1 ± 8.7 months) the first cardiac event was cardiac death in 11 patients (3.1%) and readmission for HF in 179 patients (51.9%). The composite end point was significantly higher in group II than in group I (163 events, 84.9 % vs. 27 events, 17.6%, p < 0.001). By multivariate Cox regression analysis, E/(E' × S') > 1.6 was the best independent predictor of cardiac events (hazard ratio = 4.46, 95% CI = 2.44-8.13, p = 0.001). Patients with E/(E' × S') > 1.6 at discharge and its worsening after 1 month have presented the worst prognosis (all p < 0.05). In patients with HF, E/(E' × S') > 1.6 at hospital discharge is a powerful predictor of clinical outcome particularly if it is associated with worsening.
