Table 3

Prognostic Significance of Echocardiographic Diastolic Dysfunction Measures: Single Component Studies

ModalityPatient PopulationCutoff ValuesOutcome
Mitral inflow Doppler
 E/A2,671 elderly patients, no CVD<0.7 or >1.5Incident HF
 E/A1,839 hypertensive patientsAge- and heart rate-adjusted ratio below medianCardiovascular events
 E/A3,008 Native Americans<0.6 or >1.5Death or cardiac death
 DT110 patients, EF <50%, no CAD<115 ms, persisting after 3 months’ HF treatmentDeath or transplant at 4 yrs
 Peak E2,671 elderly, no CVDContinuousIncident HF
 DT571 patients post-AMI<130 msDeath at 4 yrs
 DT79 HF patients, no CAD<115 msDeath or transplant
M-mode IVRT185 elderly HF patients≤30 msDeath
Pulmonary vein Doppler
 PV AR dur − MV A dur145 LV dysfunction patients≥30 msCardiac death or hospital stay
 S/D115 patients, EF <45%<1HF hospital readmission or HF death at 1 yr
Tissue Doppler
 E/E’250 patients post-AMI>15Death
 E/E’45 patients, NYHA functional class III or IV HFContinuousPredictor of NYHA functional class, HF hospital stay, cardiac death
 E/E’130 chronic HF patients>12.5Composite: cardiac death, HF hospital stay, urgent transplant
 E/E’110 patients hospitalized with HF≥15Cardiac death or hospital readmission for HF
 E’, E/E’518 patients referred for echocardiographyE’ <3 or 3–5 cm/s, E/E’ >20Cardiac death
Systolic mitral annular velocity185 patients, EF <45%ContinuousDeath or transplant
LA volume1,375 elderly patients with preserved EF≥ 32 ml/m2Incident HF
Flow propagation
 E/Vp67 post-MI patientsE/Vp ≥1.5Death and HF readmission
 Vp125 post-MI patientsVp <45 cm/sCardiac death

A = atrial filling velocity; AMI = acute myocardial infarction; CAD = coronary artery disease; CVD = cardiovascular disease; D = diastolic pulmonary vein wave; DT = deceleration time of E-wave; E = early diastolic filling velocity; E’ = tissue Doppler early filling velocity; EF = ejection fraction; IVRT = interventricular relaxation time; LA = left atrium; LV = left ventricle; MV A dur = mitral valve atrial wave duration; NYHA = New York Heart Association; PV AR dur = pulmonary vein atrial reversal duration; S = systolic pulmonary vein wave; Vp = flow propagation velocity slope.

  • New onset event = myocardial infarction, sudden cardiac death, unstable angina, revascularization, stroke/transient ischemic attack, hospital stay for heart failure (HF), symptomatic aorto-iliac disease, end-stage renal disease.