Use of Echocardiographic Variables in Addition to E/e’ to Improve Prediction of Elevated Left Ventricular Filling Pressures

Abstract

Introduction: Heart failure with preserved ejection fraction (HFPEF) has become an increasingly prevalent condition in recent years. Because this condition is so common and carries a mortality risk similar to that of heart failure with reduced ejection fraction [1], accurate noninvasive evaluation of left ventricular diastolic function is an important everyday task in the echocardiography laboratory. Diastolic function is often challenging to assess, requiring the reader to understand the patient’s comorbid cardiac conditions, then quantify and reconcile multiple parameters. Among patients with normal ejection fractions, the ratio of mitral inflow to mitral annular velocity (E/e’) is the recommended initial screen for the evaluation of elevated left ventricular filling pressures [2]. However, E/e’ is an imperfect index, leaving many patients in an indeterminate range. Additional methods are required to fill in such gaps.