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Mitral Peak Doppler E-wave to Peak Mitral Annulus Velocity Ratio Is an Accurate Estimate of Left Ventricular Filling Pressure and Predicts Mortality in End-stage Renal Disease

2006; Elsevier BV; Volume: 19; Issue: 3 Linguagem: Inglês

10.1016/j.echo.2005.10.006

1097-6795

Rajan Sharma, Denis Pellerin, David Gaze, Rajnikant Mehta, Helen Gregson, Christopher P. Streather, Paul Collinson, Stephen Brecker,

Cardiac Valve Diseases and Treatments

Objective The study aimed to assess whether the mitral peak Doppler E-wave to peak mitral annulus velocity ratio (E/Ea) estimates left ventricular (LV) filling pressure (LVFP) and predicts mortality in end-stage renal disease. Methods In all, 125 candidates for renal transplant were prospectively studied. LV end-diastolic pressure of 15 mm Hg or greater at cardiac catheterization was defined as elevated LVFP. Results Severe coronary artery disease, N- terminal pro-B-type natriuretic peptide level, left atrial size, flow propagation velocity, mitral E/Ea ratio, pulmonary atrial reversal velocity, and pulmonary-mitral atrial wave duration predicted an increased LVFP. However, the mitral E/Ea ratio (odds ratio 8.1, 95% confidence interval 5.1-9.6, P = .003) was the only independent predictor. An E/Ea of 15 or more, seen in 31 (25%) patients, predicted increased LVFP with sensitivity of 82% and specificity of 88%, and was associated with increased mortality (P = .005). Conclusions In end-stage renal disease, mitral E/Ea ratio 15 or higher accurately predicts increased LVFP and mortality. The study aimed to assess whether the mitral peak Doppler E-wave to peak mitral annulus velocity ratio (E/Ea) estimates left ventricular (LV) filling pressure (LVFP) and predicts mortality in end-stage renal disease. In all, 125 candidates for renal transplant were prospectively studied. LV end-diastolic pressure of 15 mm Hg or greater at cardiac catheterization was defined as elevated LVFP. Severe coronary artery disease, N- terminal pro-B-type natriuretic peptide level, left atrial size, flow propagation velocity, mitral E/Ea ratio, pulmonary atrial reversal velocity, and pulmonary-mitral atrial wave duration predicted an increased LVFP. However, the mitral E/Ea ratio (odds ratio 8.1, 95% confidence interval 5.1-9.6, P = .003) was the only independent predictor. An E/Ea of 15 or more, seen in 31 (25%) patients, predicted increased LVFP with sensitivity of 82% and specificity of 88%, and was associated with increased mortality (P = .005). In end-stage renal disease, mitral E/Ea ratio 15 or higher accurately predicts increased LVFP and mortality.