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

doi:10.1016/j.euje.2005.01.005

European Journal of Echocardiography 2005 6(6):419-428; doi:10.1016/j.euje.2005.01.005

This Article

	Full Text
	FREE Full Text (PDF)
	Alert me when this article is cited
	Alert me if a correction is posted

Services

	Email this article to a friend
	Similar articles in this journal
	Similar articles in PubMed
	Alert me to new issues of the journal
	Add to My Personal Archive
	Download to citation manager
	Request Permissions
	Disclaimer

Google Scholar

	Articles by Wallentin Guron, C.
	Articles by Caidahl, K.
	Search for Related Content

PubMed

	PubMed Citation
	Articles by Wallentin Guron, C.
	Articles by Caidahl, K.

Social Bookmarking

	What's this?

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

Cecilia Wallentin Guron^a^,*, Odd Bech-Hanssen^b, Ronny Wikh^b, Annika Rosengren^c, Marianne Hartford^d and Kenneth Caidahl^b^,e

^aDepartment of Clinical Physiology, Sahlgrenska University Hospital, SE 416 85 Göteborg, Sweden
^bDepartment of Clinical Physiology, Sahlgrenska University Hospital, SE 413 45 Göteborg, Sweden
^cDepartment of Internal Medicine, Sahlgrenska University Hospital, SE 416 85 Göteborg, Sweden
^dDepartment of Cardiology, Sahlgrenska University Hospital, SE 413 45 Göteborg, Sweden
^eDepartment of Clinical Physiology, Karolinska Institute, SE 171 76 Stockholm, Sweden

Received 15 September 2004; received in revised form 3 January 2005; accepted after revision 15 January 2005.

c.wallentin{at}home.se

^* Corresponding author. Tel.: +46 703 127772; fax: +46 31 7780551.

Abstract

Aim

A ratio >15 between the early diastolic pulsed Doppler velocitiesof the mitral inflow (E) and the basal left ventricular (LV)tissue (e) has been demonstrated to predict an elevated LV fillingpressure (FP). An elevated LVFP implies an elevated right ventricularpressure (RVp). In order to investigate the sensitivity of theE/e filling index, we compared E/e and RVp, in their abilityto identify a Doppler-assumed elevation of LVFP.

Methods and results

Application of pulsed Doppler international recommendationsgrouped 134 patients with acute coronary syndromes (ACS) and50 age- and sex-matched controls, according to LV filling: normal;delayed relaxation; an isolated pathological mitral–pulmonaryvenous-A-wave-duration difference; pseudo normal; or a restrictivefilling pattern. An E/e >15 and an RVp >30mmHg showedthe following (%) sensitivity (32/94), specificity (95/76),positive (68/59), and negative (80/97) predictive values ofa Doppler-assumed elevation of LVFP, in terms of either a pseudonormal or a restrictive filling pattern.

Conclusion

The low sensitivity of E/e to detect a Doppler-assumed elevationof LVFP could limit its clinical usefulness as a single variable,in ACS. The high sensitivity and negative predictive value ofRVp support its use as an additional LV filling variable inthese patients.

Keywords: Left ventricular filling; Diastolic function; Left ventricular filling pressure; Doppler; Tissue Doppler; Right ventricular pressure

Add to CiteULike CiteULike Add to Connotea Connotea Add to Del.icio.us Del.icio.us What's this?

This article has been cited by other articles:

P. Lindqvist, G. Wikstrom, and A. Waldenstrom
The use of E/Em and the time interval difference of isovolumic relaxation (TIVRT-IVRTm) in estimating left ventricular filling pressures
Eur J Heart Fail, May 1, 2008; 10(5): 490 - 497.
[Abstract] [Full Text] [PDF]