Noninvasive estimation of left ventricular filling pressure by E/e' is a powerful predictor of survival after acute myocardial infarction

Journal of the American College of Cardiology
Graham S HillisJae K Oh

Abstract

The aim of this study was to assess the prognostic value of a noninvasive measure of left ventricular diastolic pressure (LVDP) early after acute myocardial infarction (MI). The early diastolic velocity of the mitral valve annulus (e') reflects the rate of myocardial relaxation. When combined with measurement of the early transmitral flow velocity (E), the resultant ratio (E/e') correlates well with mean LVDP. In particular, an E/e' ratio >15 is an excellent predictor of an elevated mean LVDP. We hypothesized that an E/e' ratio >15 would predict poorer survival after acute MI. Echocardiograms were obtained in 250 unselected patients 1.6 days after admission for MI. Patients were followed for a median of 13 months. The end point was all-cause mortality. Seventy-three patients (29%) had an E/e' >15. This was associated with excess mortality (log-rank statistic 21.3, p < 0.0001) and was the most powerful independent predictor of survival (risk ratio 4.8, 95% confidence interval 2.1 to 10.8, p = 0.0002). The addition of E/e' >15 improved the prognostic utility of a model containing clinical variables and conventional echocardiographic indexes of left ventricular systolic and diastolic function (p = 0.001). E/e' is a powerful predic...Continue Reading

References

Dec 9, 1976·The New England Journal of Medicine·J S ForresterH J Swan
Sep 1, 1992·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·J K OhA J Tajik
Sep 1, 1989·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·N B SchillerI Schnittger
Apr 25, 1974·The New England Journal of Medicine·G A FooteM Hodges
Aug 11, 1983·The New England Journal of Medicine·UNKNOWN Multicenter Postinfarction Research Group
Apr 1, 1994·American Journal of Respiratory and Critical Care Medicine·L A Mermel, D G Maki
Apr 1, 1997·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·J K OhA J Tajik
Apr 1, 1997·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·C P AppletonJ K Oh
Sep 23, 1997·Postgraduate Medicine·B K Whisenant, C L Wolfe
May 16, 2000·Chest·E SiniorakisP Bonoris
Mar 27, 2001·Journal of the American College of Cardiology·A M ArrudaP A Pellikka
Oct 6, 2001·The New England Journal of Medicine·J A de LemosE Braunwald
Nov 6, 2001·Journal of the American College of Cardiology·G CerisanoD Antoniucci

❮ Previous
Next ❯

Citations

Nov 30, 2006·Current Heart Failure Reports·Jens Jakob Thune, Scott D Solomon
Apr 12, 2012·Current Heart Failure Reports·Umar A Khan, Gerard P Aurigemma
May 12, 2009·The American Journal of Cardiology·Aaron M FromHorng H Chen
Apr 17, 2010·JACC. Cardiovascular Imaging·Darryl P LeongJoseph B Selvanayagam
Jun 11, 2008·Nature Clinical Practice. Cardiovascular Medicine·Maral OuzounianPeter P Liu
Feb 11, 2012·European Heart Journal Cardiovascular Imaging·Soren HoffmannRasmus Mogelvang
Mar 24, 2009·European Heart Journal·Adisai BuakhamsriJames D Thomas
Dec 18, 2010·European Heart Journal·Frank A FlachskampfWerner G Daniel
Feb 20, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Arend Derk Jan Ten HarkelJeroen Nauta
Jul 4, 2012·Psychosomatic Medicine·Gaston K KapukuGregory Harshfield
Sep 28, 2007·Cardiovascular Ultrasound·Antti LoimaalaIlkka Vuori
Sep 7, 2007·Critical Care : the Official Journal of the Critical Care Forum·David J SturgessBala Venkatesh
Mar 25, 2010·Critical Care : the Official Journal of the Critical Care Forum·David J SturgessBala Venkatesh
Aug 30, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Hyungseop KimKwon-Bae Kim
Nov 19, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroyuki OkuraKiyoshi Yoshida
Oct 20, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Makoto MinoshimaToyoaki Murohara
Jul 30, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Sung-Ji ParkJae K Oh
Jul 31, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Shih-Hung Hsiao, Kuan-Rau Chiou
Feb 13, 2009·The Tohoku Journal of Experimental Medicine·Hisashi MasugataMasakazu Kohno

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.