E/E' ratio is more sensitive than E/A ratio for detection of left ventricular diastolic dysfunction in systemic lupus erythematosus

Abstract

To investigate whether the ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') (E/E' ratio) can detect left ventricular diastolic dysfunction more sensitively than the ratio of E to mitral peak velocity of late filling (A) (E/A ratio) in systemic lupus erythematosus (SLE). A total of 137 patients with SLE were investigated and compared with 110 age-matched and sex-matched controls retrospectively. Two-dimensional echocardiography and M-mode echocardiography including conventional and tissue Doppler imaging were performed. There were no differences in the left ventricle ejection fractions and the mean E/A ratio between the two groups. However, the mean E/E' ratio of patients was higher than that of the controls (10.4 +/- 4.0 vs 7.7 +/- 2.1, P < 0.01). Significantly higher left ventricle ejection fractions and lower E/E' ratio were found in patients with systemic lupus erythematosus receiving angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker than those not receiving (P < 0.05). Our study showed that the E/E' ratio is more sensitive than the E/A ratio for detection of the left ventricle diastolic dysfunction. Furthermore, patients who had received angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment showed significantly better preservation of both systolic and diastolic function of left ventricle in comparison with those who had not received.

Assessment of left ventricular structure and function in preeclampsia by echocardiography and cardiovascular biomarkers

“…The ratio of transmitral E wave velocity to myocardial E 0 velocity measured by DTI, E/E 0 , has been validated and widely accepted as a noninvasive surrogate measure of LV filling pressure in the general population, in patients with hypertension [32], systemic lupus erythematosus [33] as well as in preeclampsia [34]. In addition, it has been suggested to be a useful and more reliable index for evaluating the LV diastolic function than E/A ratio only.…”

Cardiac dysfunction in juvenile dermatomyositis: a case-control study

“…It is possible that the myocardium in patients with JDM can be affected by inflammation, as seen in the adult form. This may influence particularly left ventricular diastolic function, as observed in other rheumatic diseases 1213. In a study on JDM from 1980, pathological ECG was present in 10 of 21 patients 14.…”

Prevalence and Outcome of Diastolic Dysfunction in Children With Fluid Refractory Septic Shock—A Prospective Observational Study*

“…This compensatory phenomenon is lost in patients with diastolic dysfunction, resulting in reduced left ventricular (LV) filling and stroke volume (10)(11)(12)(13)(14)(15). Diastolic function is assessed by standard measures of ventricular relaxation or adenosine triphosphate-dependent part of ventricular diastole that include E wave, A wave, E/A ratio, E′, A′, and myocardial performance index or Tei index by Doppler echocardiography (16)(17)(18)(19). Of all these variables, early diastolic mitral annular velocity (E′), as measured by tissue Doppler imaging (TDI), reflects LV relaxation and is mostly independent of both preload and heart rate (18).…”