The E/e filling index and right ventricular pressure in relation to applied international Doppler recommendations of left ventricular filling assessment.

Full Abstract

AIM: A ratio>15 between the early diastolic pulsed Doppler velocities of the mitral inflow (E) and the basal left ventricular (LV) tissue (e) has been demonstrated to predict an elevated LV filling pressure (FP). An elevated LVFP implies an elevated right ventricular pressure (RVp). In order to investigate the sensitivity of the E/e filling index, we compared E/e and RVp, in their ability to identify a Doppler-assumed elevation of LVFP. METHODS AND RESULTS: Application of pulsed Doppler international recommendations grouped 134 patients with acute coronary syndromes (ACS) and 50 age- and sex-matched controls, according to LV filling: normal; delayed relaxation; an isolated pathological mitral-pulmonary venous-A-wave-duration difference; pseudo normal; or a restrictive filling pattern. An E/e>15 and an RVp>30 mmHg showed the following (%) sensitivity (32/94), specificity (95/76), positive (68/59), and negative (80/97) predictive values of a Doppler-assumed elevation of LVFP, in terms of either a pseudo normal or a restrictive filling pattern. CONCLUSION: The low sensitivity of E/e to detect a Doppler-assumed elevation of LVFP could limit its clinical usefulness as a single variable, in ACS. The high sensitivity and negative predictive value of RVp support its use as an additional LV filling variable in these patients.

Author information

Author/s: Wallentin Guron, Cecilia (C); Bech-Hanssen, Odd (O); Wikh, Ronny (R); Rosengren, Annika (A); Hartford, Marianne (M); Caidahl, Kenneth (K);

Affiliation: Department of Clinical Physiology, Sahlgrenska University Hospital, SE 416 85 Göteborg, Sweden. c.wallentin(-atsign-)home.se

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology (Eur J Echocardiogr), published in England. (Language: eng)

Reference: 2005-Dec; vol 6 (issue 6) : pp 419-28

Dates: Created 2005/11/18; Completed 2006/01/05; Revised 2008/11/21;

PMID: 16293528, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.