Tissue Doppler-derived index of left ventricular filling pressure, E/E', predicts survival of patients with non-valvular atrial fibrillation.
OBJECTIVE
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' <or= 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' (chi(2) = 4.47, odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01 to 1.11, p = 0.03) and age (chi(2) = 6.45, OR 1.06, 95% CI 1.01 to 1.11, p = 0.02) were independent predictors of mortality.


CONCLUSIONS
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.
Okura
H
H
Division of Cardiology, Bell Land General Hospital, Sakai, Japan. hokura@fides.dti.ne.jp
Takada
Y
Y
Kubo
T
T
Iwata
K
K
Mizoguchi
S
S
Taguchi
H
H
Toda
I
I
Yoshikawa
J
J
Yoshida
K
K
D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000401:mortality; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012044:Regression Analysis; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality