Mitral Valve Doppler E/e’ as a Prognostic Marker in Acute Myocardial Infarction
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Background: The early diastolic tissue Doppler velocity of the mitral valve annulus (e_) reflects the rate of myocardial relaxation. In combination with measurement of the early transmitral flow velocity (E), the resultant ratio (E/e’) correlates well with mean left ventricular end diastolic pressure (LVEDP). In particular, an E/e’ ratio >15 is a valuable predictor of an elevated mean LVEDP. We proposed that an E/e’ ratio >15 would predict lower survival after acute myocardial infarction (MI). Materials and Methods: Transthoracic echocardiograms were obtained in 50 consecutive patients immediately after admission for MI. The patients were followed up until their hospital discharge. The end point was all-cause mortality. Results: E/e’ had a strong correlation in predicting death as an outcome of the total of 16 patients with an E/e’ ratio of >15 suggestive of elevated LV filling pressures 0.6 of these patients did not survive to hospital discharge amounting to a mortality rate of 37.5% in that group (average mortality 14%). In contrast in patients who had an E/e’ ratio of <15 the mortality rate was low at 2.94%. Conclusions: Thus, E/e’ ratio can be used as a surrogate marker of elevated LV filling pressure and hence can be reliably used as a prognostic marker to risk stratify patients admitted in coronary care units over and above other non-invasive tools already available.
Authors and Affiliations
R Ramesh
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