Elevation of the ratio of transmitral E velocity to early diastolic mitral annular velocity continues even after recovery from acute stage in patients with diastolic heart failure

SummaryBackgroundClinical features of diastolic heart failure (DHF) have not been well characterized, leading to an inaccuracy in the diagnosis of DHF. Recently, the ratio of transmitral E velocity to early diastolic mitral annular velocity (E/E′) has been shown to be useful to assess LV filling pressure.PurposeWe tested the hypothesis that persistent elevation of E/E′ ratio is one of the characteristics of patients with DHF.MethodsCandidates of this study were 89 patients who presented to the emergency department because of acute pulmonary congestion. Those with an ejection fraction of >45% on admission comprised the DHF group (n = 18). A control group consisted of consecutive 30 hypertensive patients with an ejection fraction of >45%. Doppler echocardiographic data were obtained with plasma BNP measure in the chronic stage >6 months after the emergent admission.ResultsThe E/E′ ratio was higher in the DHF group than in the control group (16.7 ± 2.8 vs. 9.4 ± 3.3, p < 0.01). BNP level was also elevated in the DHF group.ConclusionA persistent elevation of E/E′ ratio may be an indicator of patients with or at risk of DHF among subjects with preserved systolic function independent of LV hypertrophy.