The predictive role of E/e′ on ischemic stroke and atrial fibrillation in Japanese patients without atrial fibrillation

Arai, Riku; Suzuki, Shinya; Semba, Hiroaki; Arita, Takuto; Yagi, Nobuyuki; Otsuka, Takayuki; Sagara, Koichi; Sasaki, Kenji; Kuwabara, Hiroto; Matsuno, Seiki; Kato, Yuko; Uejima, Tokuhisa; Oikawa, Yuji; Kunihara, Takashi; Yajima, Junji; Yamashita, Takeshi

doi:10.1016/j.jjcc.2018.01.001

Cited by 13 publications

(10 citation statements)

References 37 publications

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“…Furthermore, Arai et al demonstrated that an E/e' ratio >11 was an independent risk factor for new-onset AF. 21 In the present study, patients in the highest E/e' ratio quartile had a 2-fold higher prevalence of PAF than those in the lowest quartile ( Table 3).…”

Section: Sources Of Fundingsupporting

confidence: 47%

Left Ventricular Diastolic Dysfunction Is Associated With the Prevalence of Paroxysmal Atrial Fibrillation Determined on the Latest Echocardiographic Criteria

et al. 2020

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Background: The relationship between left ventricular diastolic dysfunction (LVDD) and paroxysmal atrial fibrillation (PAF) remains unclear because of a lack of standard measures to evaluate LVDD. Accordingly, we examined the association between the prevalence of PAF and each LVDD grade determined according to the latest American Society of Echocardiography guidelines. Methods and Results: In all, 2,063 patients without persistent AF who underwent echocardiography at Saitama Municipal Hospital from July 2016 to June 2017 were included in the study. Patients were divided into LVDD 6 categories: No-LVDD (n=1,107), Borderline (n=392), Grade 1 (n=204), Indeterminate (n=62), Grade 2 (n=254), and Grade 3 (n=44). PAF was documented in 111 (10.0%), 81 (20.7%), 28 (13.7%), 6 (9.7%), 52 (20.5%), and 24 (54.5%) patients in the No-LVDD, Borderline, Grade 1, Indeterminate, Grade 2, and Grade 3 categories, respectively. PAF prevalence was higher in patients with Grade 3 LVDD across the whole study population. Subgroup analyses showed that the prevalence of PAF increased with increased LVDD grade in patients with reduced left ventricular ejection fraction. This relationship was significant in multivariate analysis including various patient characteristics. Conclusions: LVDD severity determined on the basis of the latest echocardiographic criteria was associated with the prevalence of PAF. The present findings shed light on the development of new therapeutic markers for PAF.

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Section: Sources Of Fundingsupporting

confidence: 47%

Left Ventricular Diastolic Dysfunction Is Associated With the Prevalence of Paroxysmal Atrial Fibrillation Determined on the Latest Echocardiographic Criteria

et al. 2020

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“…E/e' is commonly used as a surrogate of LV filling pressure [16] and reflects the severity of heart failure [30] . Blood pressure is maintained in patients with a high E/e' with a negative fluid balance by administration of furosemide or continuous hemofiltration [31] .…”

Section: Post-induction Hypotension In Patients With Cardiovascular D...mentioning

confidence: 99%

Risk factors including preoperative echocardiographic parameters for post-induction hypotension in general anesthesia

Tarao

Daimon

Son

et al. 2021

Journal of Cardiology

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“…These patients were referred for a comprehensive cardiovascular evaluation by their general practitioners thus reflecting a primary care setting. The clinical question was to assess whether the available evidence reported in multiple, different experimental settings [1][2][3][4][19][20][21] may be duplicated in the heterogeneous clinical scenario encountered in every day clinical practice. During a midterm follow-up, e' and E/e' were both associated with clinical outcome in these patients, but only e' maintained its independent prognostic information in multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

“…When used in conjunction with mitral peak early filling velocity (E), the E/e' ratio is a widely used noninvasive estimate of LV filling pressure (LVFP) that plays a pivotal role in evaluating diastolic dysfunction [5]. Although the prognostic value of E/e' is established, a number of studies have raised concerns about its diagnostic accuracy in various cardiovascular conditions [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Tissue Doppler indices of diastolic function as prognosticator in patients without heart failure in primary care

Nistri¹,

Mazzone

Cioffi

et al. 2020

Journal of Cardiology

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Background: Tissue Doppler imaging (TDI) indices of left ventricular (LV) diastolic function provide incremental prognostic information on mortality and morbidity in the general population and in several clinical scenarios. Their independent, additional role in outpatients with normal LV ejection fraction (LVEF) and without heart failure (HF) is undefined. Methods: We reviewed clinical and echocardiographic records of 2628 consecutive outpatients 52.8% male, median age 71 years) with LVEF > 50% without concurrent or prior HF, from the Cardiovascular Center of Trieste. We analyzed septal early mitral annular velocity (e') and its combination with mitral peak early filling velocity (E/e') in relation to the composite end-point of death and cardiovascular hospitalizations. Results: During follow-up of 26 months (interquartile range: 12-41), 392 (15%) patients experienced the endpoint (88 deaths). Increasing E/e' showed an overall association with the clinical end-point (log rank p < 0.02), but with no prognostic difference between the middle and upper tertile. Decreasing e' also showed an association with the end-point, with a more balanced stepwise risk increase for increasing tertiles (log rank p < 0.01 for all contrasts). At multivariable analysis, E/e' (either in tertiles or dichotomized according to the threshold of 15) was no longer associated with clinical outcome, whereas e' independently predicted the combined endpoint [hazard ratio 0.73 (0.53-0.94), p = 0.04]. The prognostic value of e' was incremental to that of other clinical and echocardiographic variables (p = 0.04). Conclusions: In outpatients with normal LVEF and without HF, e' and E/e' are both associated with clinical end-points, though only e' is an independent and incremental predictor of outcome. These findings suggest a potential role for e' as a prognosticator, and spread a cautionary word about the utilization of septal E/e' alone as a surrogate for a comprehensive assessment of diastolic function in this context.

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The predictive role of E/e′ on ischemic stroke and atrial fibrillation in Japanese patients without atrial fibrillation

Abstract: E/e' was significantly associated with incidence of IS and new appearance of AF in non-AF patients.

Cited by 13 publications

References 37 publications

Left Ventricular Diastolic Dysfunction Is Associated With the Prevalence of Paroxysmal Atrial Fibrillation Determined on the Latest Echocardiographic Criteria

Left Ventricular Diastolic Dysfunction Is Associated With the Prevalence of Paroxysmal Atrial Fibrillation Determined on the Latest Echocardiographic Criteria

Risk factors including preoperative echocardiographic parameters for post-induction hypotension in general anesthesia

Tissue Doppler indices of diastolic function as prognosticator in patients without heart failure in primary care

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