Abstract
To the Editor: I read with interest the article by Mullens et al1 about patients with severe heart failure, and I agree with their important warning that using annular tissue Doppler velocity indices as the sole predictors of elevated left ventricular (LV) filling pressure is inaccurate. Some points in the article deserve additional clarification. The authors cite published data on the ratio of early transmitral velocity to tissue Doppler mitral annular early diastolic velocity (E/Ea) with pulmonary capillary wedge pressure (PCWP) in a wide range of cardiac patients. However, the strength of the correlation in the validation articles2,3 may not justify the use of the …
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