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The E/e filling index and right ventricular pressure in relation to applied international Doppler recommendations of left ventricular filling assessment

Journal article
Authors Cecilia Wallentin Guron
Odd Bech-Hanssen
R. Wikh
Annika Rosengren
Marianne Hartford
Kenneth Caidahl
Published in Eur J Echocardiogr
Volume 6
Issue 6
Pages 419-28
ISSN 1525-2167 (Print)
Publication year 2005
Published at Cardiovascular Institute
Institute of Internal Medicine
Institute of Physiology and Pharmacology, Dept of Physiology
Pages 419-28
Language en
Keywords Aged, Coronary Disease/physiopathology/ultrasonography, *Echocardiography, Doppler, Pulsed, Female, Heart Ventricles/physiology/*ultrasonography, Humans, Male, Middle Aged, Mitral Valve/physiology/ultrasonography, Predictive Value of Tests, Reproducibility of Results, Sensitivity and Specificity, *Ventricular Function, Left, *Ventricular Function, Right, *Ventricular Pressure
Subject categories Cardiac and Cardiovascular Systems


AIM: A ratio>15 between the early diastolic pulsed Doppler velocities of the mitral inflow (E) and the basal left ventricular (LV) tissue (e) has been demonstrated to predict an elevated LV filling pressure (FP). An elevated LVFP implies an elevated right ventricular pressure (RVp). In order to investigate the sensitivity of the E/e filling index, we compared E/e and RVp, in their ability to identify a Doppler-assumed elevation of LVFP. METHODS AND RESULTS: Application of pulsed Doppler international recommendations grouped 134 patients with acute coronary syndromes (ACS) and 50 age- and sex-matched controls, according to LV filling: normal; delayed relaxation; an isolated pathological mitral-pulmonary venous-A-wave-duration difference; pseudo normal; or a restrictive filling pattern. An E/e>15 and an RVp>30 mmHg showed the following (%) sensitivity (32/94), specificity (95/76), positive (68/59), and negative (80/97) predictive values of a Doppler-assumed elevation of LVFP, in terms of either a pseudo normal or a restrictive filling pattern. CONCLUSION: The low sensitivity of E/e to detect a Doppler-assumed elevation of LVFP could limit its clinical usefulness as a single variable, in ACS. The high sensitivity and negative predictive value of RVp support its use as an additional LV filling variable in these patients.

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