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E/a´ ratio a simple detector of left ventricular dysfunction in patients with decreased ejection fraction

Benny Johansson1, Fredrik Lundin2, Rolf Tegerback3

  • 1a Department of Clinical Physiology , Örebro University Hospital , Örebro , Sweden.

Scandinavian Cardiovascular Journal : SCJ
|December 15, 2017
PubMed

Insights

The E/a´ ratio effectively screens for diastolic dysfunction and high left ventricular filling pressure in patients with reduced ejection fraction. This ratio aids in rapidly identifying or ruling out these conditions, improving patient assessment.

Area of Science:

  • Cardiology
  • Echocardiography
  • Diastolic Function

Background:

  • Diastolic dysfunction and increased left ventricular (LV) filling pressure are common in patients with reduced ejection fraction (EF).
  • Accurate assessment of diastolic function is crucial for guiding treatment and improving outcomes in these patients.

Purpose of the Study:

  • To determine if the E/a´ ratio can detect or rule out diastolic dysfunction and elevated LV filling pressure according to ASE/EACVI guidelines in patients with decreased EF.
  • To evaluate the diagnostic performance of the E/a´ ratio for identifying diastolic dysfunction.

Main Methods:

  • Retrospective evaluation of diastolic function in 113 in-hospital patients (aged 40-84) with EF ≤50% and sinus rhythm.
  • Comparison of diastolic function assessed by ASE/EACVI guidelines with the E/a´ ratio derived from mitral inflow (E wave) and tissue Doppler (a´ velocity).

Main Results:

  • The average E/a´ ratio strongly predicts grade II-III diastolic dysfunction and elevated left atrial pressure (AUC of 0.92).
  • An E/a´ ratio cut-off >10 demonstrated high sensitivity (97.6%) and negative predictive value (98.2%) for detecting or ruling out grade II-III diastolic dysfunction and elevated left atrial pressure.

Conclusions:

  • The average E/a´ ratio serves as a valuable and rapid screening tool for LV dysfunction and increased LV filling pressure in patients with reduced EF.
  • This ratio can efficiently aid clinicians in assessing diastolic function in this patient population.
Abstract

Keywords:
ASE/EACVI guidelinesE/a´ratioS/D ratioa´velocitydiastolic dysfunctionejection fractiontissue doppler

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