Mitral peak Doppler E-wave to peak mitral annulus velocity ratio is an accurate estimate of left ventricular filling pressure and predicts mortality in end-stage renal disease

J Am Soc Echocardiogr. 2006 Mar;19(3):266-73. doi: 10.1016/j.echo.2005.10.006.

Abstract

Objective: The study aimed to assess whether the mitral peak Doppler E-wave to peak mitral annulus velocity ratio (E/Ea) estimates left ventricular (LV) filling pressure (LVFP) and predicts mortality in end-stage renal disease.

Methods: In all, 125 candidates for renal transplant were prospectively studied. LV end-diastolic pressure of 15 mm Hg or greater at cardiac catheterization was defined as elevated LVFP.

Results: Severe coronary artery disease, N- terminal pro-B-type natriuretic peptide level, left atrial size, flow propagation velocity, mitral E/Ea ratio, pulmonary atrial reversal velocity, and pulmonary-mitral atrial wave duration predicted an increased LVFP. However, the mitral E/Ea ratio (odds ratio 8.1, 95% confidence interval 5.1-9.6, P = .003) was the only independent predictor. An E/Ea of 15 or more, seen in 31 (25%) patients, predicted increased LVFP with sensitivity of 82% and specificity of 88%, and was associated with increased mortality (P = .005).

Conclusions: In end-stage renal disease, mitral E/Ea ratio 15 or higher accurately predicts increased LVFP and mortality.

Publication types

  • Clinical Trial

MeSH terms

  • Blood Pressure
  • Comorbidity
  • Cross-Sectional Studies
  • Echocardiography, Doppler / statistics & numerical data*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Incidence
  • Kidney Failure, Chronic / diagnostic imaging*
  • Kidney Failure, Chronic / mortality*
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging*
  • Risk Assessment / methods
  • Risk Factors
  • Survival Analysis
  • United Kingdom / epidemiology
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / mortality*