A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure

Diastolic dysfunction represents a combination of impaired left ventricular (LV) relaxation, restoration forces, myocyte lengthening load, and atrial function, culminating in increased LV filling pressures. Current Doppler echocardiography guidelines recommend using early to late diastolic transmitr...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2017-03, Vol.69 (11), p.1451-1464
Main Authors: Mitter, Sumeet S, Shah, Sanjiv J, Thomas, James D
Format: Article
Language:English
Subjects:
Abnormalities
Cardiology
Clinical Decision-Making
Compliance
Decision making
Diagnostic systems
Doppler effect
Echocardiography
Flow velocity
Heart
Heart failure
Heart Failure, Diastolic - diagnostic imaging
Heart Failure, Diastolic - physiopathology
Hemodynamics
Humans
Hypertension
Physics
Physiology
Prognosis
Ventricle
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Diastolic dysfunction represents a combination of impaired left ventricular (LV) relaxation, restoration forces, myocyte lengthening load, and atrial function, culminating in increased LV filling pressures. Current Doppler echocardiography guidelines recommend using early to late diastolic transmitral flow velocity (E/A) to assess diastolic function, and E to early diastolic mitral annular tissue velocity (E/e') to estimate LV filling pressures. Although both parameters have important diagnostic and prognostic implications, they should be interpreted in the context of a patient's age and the rest of the echocardiogram to describe diastolic function and guide patient management. This review discusses: 1) the physiological basis for the E/A and E/e' ratios; 2) their roles in diagnosing diastolic dysfunction; 3) prognostic implications of abnormalities in E/A and E/e'; 4) special scenarios of the E/A and E/e' ratios that are either useful or challenging when evaluating diastolic function clinically; and 5) their usefulness in guiding therapeutic decision making.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2016.12.037