Mitral peak Doppler E-wave to peak mitral annulus velocity ratio is an accurate estimate of left ventricular filling pressure and predicts mortality in end-stage renal disease.
OBJECTIVE
The study aimed to assess whether the mitral peak Doppler E-wave to peak mitral annulus velocity ratio (E/Ea) estimates left ventricular (LV) filling pressure (LVFP) and predicts mortality in end-stage renal disease.


METHODS
In all, 125 candidates for renal transplant were prospectively studied. LV end-diastolic pressure of 15 mm Hg or greater at cardiac catheterization was defined as elevated LVFP.


RESULTS
Severe coronary artery disease, N- terminal pro-B-type natriuretic peptide level, left atrial size, flow propagation velocity, mitral E/Ea ratio, pulmonary atrial reversal velocity, and pulmonary-mitral atrial wave duration predicted an increased LVFP. However, the mitral E/Ea ratio (odds ratio 8.1, 95% confidence interval 5.1-9.6, P = .003) was the only independent predictor. An E/Ea of 15 or more, seen in 31 (25%) patients, predicted increased LVFP with sensitivity of 82% and specificity of 88%, and was associated with increased mortality (P = .005).


CONCLUSIONS
In end-stage renal disease, mitral E/Ea ratio 15 or higher accurately predicts increased LVFP and mortality.
Sharma
Rajan
R
Department of Cardiology, Chemical Pathology, St George's Hospital, London, United Kingdom. rajdoc.Sharma@tiscali.co.uk
Pellerin
Denis
D
Gaze
David C
DC
Mehta
Rajnikant L
RL
Gregson
Helen
H
Streather
Christopher P
CP
Collinson
Paul O
PO
Brecker
Stephen J D
SJ
D001794:Blood Pressure; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality*