Author + information
- Giovanni Benfari,
- Clemence Antoine,
- Wayne Miller,
- Hector Michelena,
- Vuyisile Nkomo and
- Maurice Sarano
Introduction: E/e’ estimates the ventricular filling pressure in the context of left ventricular dysfunction (LVD), and is well related to invasive measurements. However, because of its complex pathophysiological interactions, E/e's specific prognostic impact has always been difficult to clarify. Large and extensively characterized series are essential to define the actual impact of E/e’ on survival.
Methods: Consecutive patients with LVD (EF <50%), a complete evaluation of clinical status, diastolic parameters, atrial volume, and pulmonary pressure (sPAP), have been enrolled at Mayo Clinic from 2003 to 2011. Organic valve disease and previous valve surgery were excluded. Endpoint was mortality under medical management.
Results: Complete data were obtained for 12421 patients, age 68 ±14 years, 31% female, EF 36 ±10%, and mean E/e’ 17 ±9. Patients with higher E/e’ were older, with more comorbidities, dyspnea, mitral regurgitation (MR), higher sPAP, and lower EF.
Mean follow up was 4.3 ±3.5 years. E/e’ significantly impacted short- and long-term survival (figure); no plateau effect was detected. Unadjusted mortality hazard for each 5 unit E/e’ increase was 1.15 [1.13-1.16], p <0.0001, and 1.07 [1.05-1.08], p<0.0001 after adjusting for age, sex, EF, MR, sPAP, symptoms, and comorbidities
Conclusions: E/e’ is a quantitative parameter independently associated to worse short- and long-term survival in LVD patients. E/e’ role should be considered in risk stratification for trials and guidelines.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 4:15 p.m.-4:25 p.m.
Session Title: Technical Advances in Transthoracic Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1264M-07
- 2017 American College of Cardiology Foundation