Elevation of the ratio of transmitral E velocity to early diastolic mitral annular velocity continues even after recovery from acute stage in patients with diastolic heart failure.

ABSTRACT

BACKGROUND: Clinical features of diastolic heart failure (DHF) have not been well characterized, leading to an inaccuracy in the diagnosis of DHF. Recently, the ratio of transmitral E velocity to early diastolic mitral annular velocity (E/E') has been shown to be useful to assess LV filling pressure. PURPOSE: We tested the hypothesis that persistent elevation of E/E' ratio is one of the characteristics of patients with DHF. METHODS: Candidates of this study were 89 patients who presented to the emergency department because of acute pulmonary congestion. Those with an ejection fraction of >45% on admission comprised the DHF group (n=18). A control group consisted of consecutive 30 hypertensive patients with an ejection fraction of >45%. Doppler echocardiographic data were obtained with plasma BNP measure in the chronic stage >6 months after the emergent admission. RESULTS: The E/E' ratio was higher in the DHF group than in the control group (16.7±2.8 vs. 9.4±3.3, p<0.01). BNP level was also elevated in the DHF group. CONCLUSION: A persistent elevation of E/E' ratio may be an indicator of patients with or at risk of DHF among subjects with preserved systolic function independent of LV hypertrophy.