The usefulness of combined assessment of E/E' ratio and transmitral flow pattern to interpret cardiac condition

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  • The usefulness of combined assessment of E/E′ ratio and transmitral flow pattern to interpret cardiac condition

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<p>Background: High mitral inflow early (E) velocity to tissue Doppler E′ ratio (E/E′) and an E to late diastolic filling velocity ratio (E/A) are used to evaluate left ventricular (LV) diastolic function and filling pressure, but the usefulness of combined assessment of E/E′ and E/A is not fully understood. Methods: We retrospectively analyzed 1,266 patients who underwent echocardiography to assess cardiac function. Patients were grouped based on the values of E/E′ (low E/E′<15, high E/E′≥15) and E/A (low E/A≤0.8, high E/A>0.8). Results: High E/E′ with both high and low E/A groups showed lower LV ejection fraction and higher LV mass index compared to low E/E′ with both high and low E/A groups. High E/E′ with both high and low E/A groups showed slower E′ velocity and larger left atrial volume index compared to low E/E′ with both high and low E/A groups, but high E/E′ with low E/A group exhibited smaller left atrial volume index and higher pulmonary venous systolic to diastolic peak velocity ratio compared to high E/E′ with high E/A group. Moreover, high E/E′ with low E/A group displayed lower tricuspid regurgitant pressure gradient than the high E/E′ with high E/A group. Conclusion: Even in the situation of high E/E′, low E/A condition indicated lower LV filling pressure and controlled fluid retention.</p>

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