ஆஞ்சியோலஜி: திறந்த அணுகல்
திறந்த அணுகல்

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Validation of Established Standard Values for the Correlation of E/e’ Ratio and Left Ventricular Diastolic Pressure in a Study of 190 Patients with Dyspnea– What are the Main Factors for the Observed Discrepancies?

Janusz N, Neikes F, von der Recke G, Kubini R, Frede S, Jörgens CH and Omran H

Aim: In the past, Mitral E/e’ ratio has been recommended for detecting elevated left ventricular filling pressures. However, more recently, gender specific differences in E/e´ ratios have been demonstrated. The aim of this prospective study was to validate the established standard values for the correlation of E/e´ ratio and left ventricular end diastolic pressure LVEDP in 190 consecutive patients with dyspnea in terms of age and gender differences.

Methods and results: 190 patients had sufficient echogenicity to allow complete assessment of the Doppler and tissue Doppler parameters. Overall, there was only a weak significant correlation between E/e´ ratio and LVEDP pre laevo cardiography (R=0.24, P=0.006). In patients with ejection fraction (EF) > 50% there was no significant correlation. Female patients had higher baseline E/e’ ratios than male patients. An E/e’ ratio > 15 for predicting an elevated LVEDP was only significant in male but not in female patients. E/e´ ratio increases progressively with age and is remarkable higher in women than in men. Irrespective of gender, a stratification of E/e’ ratio < 8, 8-15 and > 15 did not allow prediction of LVEDP.

Conclusions: Only male patients showed a significant correlation (R = 0.29, P = 0.012) between their E/e’ and LVEDP with respect to difference in gender. Excessively high E/e´ ratios measured in women were less pathognomonic for diastolic dysfunction than in men.