O9-2 - (E/E')/Sv is a Better Predictor of Outcome Than E/E' in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction

Abstract

Background and Objective: Predictors of outcome in patients with heart failure with preserved left ventricular ejection fraction (HFpEF) remain unclear. The ratio of early diastolic transmitral velocity to early diastolic tissue velocity (E/e') has been proposed as one of them, but the predictive accuracy remains insufficient. We hypothesized(E/e')/SV, E/e' normalized by the stroke volume (SV), may be a better predictor of outcome in patients with HFpEF than E/e', by reflecting the terminal slope of the end-diastolic pressure-volume relation, i.e., stiffness of the left ventricle. Methods: Echocardiography including (E/e')/SV measurement was performed in consecutive 43 patients of HFpEF before discharge (female 22 patients (51%), age 78 ± 9 years old). Patients were followed for a median of 6.5 months. The end points included the admission for heart failure and cardiovascular death. Results: During the follow-up, 9 patients (21%) encountered the end points. In ROC analysis, (E/e')/SV was a better predictive factor than E/e' ((E/e')/SV AUC = 0.820, E/e' AUC = 0.768). Kaplan-Meier analysis showed patients with high(E/e')/SV (>0.420) had poor prognosis (P < .01). Conclusion: (E/e')/SV is a better predictor of outcome than E/e'in patients with HFpEF.