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Is E/E' reliable in patients with regional wall motion abnormalities to estimate left ventricular filling pressure?

Lim, HS; Kang, SJ; Choi, JH; Ahn, SG; Choi, BJ; Choi, SY; Yoon, MH; Hwang, GS; Tahk, SJ; Shin, JH
The international journal of cardiovascular imaging, 25(1):33-39, 2009
Journal Title
The international journal of cardiovascular imaging
BACKGROUND: There is limited data on the diagnostic utility of the transmitral to mitral annular velocity (E/E') by tissue Doppler imaging (TDI) in the presence of regional wall motion abnormalities (RWMA). We aimed to investigate whether the E/E' is reliable in estimating left ventricular filling pressure (LVFP) despite RWMA.

METHODS: One hundred thirty consecutive patients with myocardial infarction (MI) and subsequent RWMA referred for cardiac catheterization and echocardiography to measure LV pre-A pressure (LVP(PRE-A)) and Doppler signals from the mitral inflow with tissue Doppler imaging (TDI) of the mitral annulus. All patients were classified into three groups according to RWMA of the segment adjacent to the E'-measuring point using TDI: 83 patients with normal wall motions of the basal septal and basal lateral segments (group A); 28 patients with RWMA of the basal septum (group B); and 19 patients with RWMA of the basal lateral segment (group C).

RESULTS: Septal E/E' correlated with LVP(PRE-A) in groups A and C (r = 0.383, P < 0.001; r = 0.482, P = 0.037, respectively). Lateral E/E' and LVP(PRE-A) showed good correlation in groups A, B and C (r = 0.470, P < 0.001; r = 0.416, P = 0.028; r = 0.727, P < 0.001, respectively). The largest area under the receiver operating curve was obtained by the lateral E/E' for the prediction of a high LVFP, irrespective of the location of RWMA.

CONCLUSIONS: In selected patients with abnormal wall motion of the basal septum, E/E' measured at the septum was not representative for LVFP. Lateral E/E' is reliable for the prediction of high LVFP, regardless of the site of RWMA.
MeSH terms
Analysis of VarianceCoronary AngiographyEchocardiography, Doppler/methods*FemaleHeart CatheterizationHemodynamicsHumansMaleMiddle AgedMitral Valve/physiopathology*Mitral Valve/ultrasonography*Myocardial Infarction/physiopathology*Myocardial Infarction/ultrasonographyROC CurveVentricular Dysfunction, Left/physiopathology*Ventricular Dysfunction, Left/ultrasonography*Ventricular Pressure/physiology*
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
임, 홍석강, 수진최, 병주최, 소연윤, 명호황, 교승탁, 승제신, 준한
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