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Tissue Doppler-derived index of left ventricular filling pressure, E/E′, predicts survival of patients with non-valvular atrial fibrillation
  1. H Okura1,
  2. Y Takada1,
  3. T Kubo1,
  4. K Iwata1,
  5. S Mizoguchi1,
  6. H Taguchi1,
  7. I Toda1,
  8. J Yoshikawa2,
  9. K Yoshida3
  1. 1Division of Cardiology, Bell Land General Hospital, Sakai, Japan
  2. 2Department of Internal Medicine and Cardiology, Osaka Ekisaikai Hospital, Osaka, Japan
  3. 3Division of Cardiology, Kawasaki Medical School, Kurashiki, Japan
  1. Correspondence to:
    Dr Hiroyuki Okura
    Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama 701-0192, Japan; hokura{at}fides.dti.ne.jp

Abstract

Objectives: To investigate whether the ratio of early transmitral flow velocity (E) to early diastolic mitral annular velocity (E′) predict prognosis in patients with non-valvular atrial fibrillation.

Methods: 230 patients with non-valvular atrial fibrillation were enrolled and studied. According to E/E′ value, patients were divided into groups with lower (group A with E/E′ ⩽ 15) and higher (group B with E/E′ > 15) E/E′.

Results: During follow up (average 245 days), 21 (9.1%) deaths were documented. All cause death (15/90 (16.7%) v 6/140 (4.3%)), cardiac death (10 (11.1%) v 2 (1.4%)) and congestive heart failure (16 (17.8%) v 8 (5.7%)) were more common in group B than in group A (all p < 0.01). A Kaplan–Meier survival curve showed that the cumulative survival rate was significantly lower in group B than in group A (log rank p  =  0.0013). By multivariate logistic regression analysis, E/E′ (χ2  =  4.47, odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01 to 1.11, p  =  0.03) and age (χ2  =  6.45, OR 1.06, 95% CI 1.01 to 1.11, p  =  0.02) were independent predictors of mortality.

Conclusion: The Doppler-derived index of left ventricular filling pressure, E/E′, is a powerful predictor of the clinical outcome of patients with non-valvular atrial fibrillation.

  • E, early transmitral filling velocity
  • E′, early diastolic mitral annular velocity
  • EF, ejection fraction
  • LV-DT, deceleration time of early transmitral flow velocity
  • PV-DT, deceleration time of diastolic peak pulmonary venous flow velocity

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Footnotes

  • Published Online First 31 January 2006

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