title: Is E/E' reliable in patients with regional wall motion abnormalities to estimate left ventricular filling pressure?
abstract: BACKGROUND
  There is limited data on the diagnostic utility of the transmitral to mitral annular velocity (E/E') by tissue Doppler imaging (TDI) in the presence of regional wall motion abnormalities (RWMA). We aimed to investigate whether the E/E' is reliable in estimating left ventricular filling pressure (LVFP) despite RWMA.
  
  
  METHODS
  One hundred thirty consecutive patients with myocardial infarction (MI) and subsequent RWMA referred for cardiac catheterization and echocardiography to measure LV pre-A pressure (LVP(PRE-A)) and Doppler signals from the mitral inflow with tissue Doppler imaging (TDI) of the mitral annulus. All patients were classified into three groups according to RWMA of the segment adjacent to the E'-measuring point using TDI: 83 patients with normal wall motions of the basal septal and basal lateral segments (group A); 28 patients with RWMA of the basal septum (group B); and 19 patients with RWMA of the basal lateral segment (group C).
  
  
  RESULTS
  Septal E/E' correlated with LVP(PRE-A) in groups A and C (r = 0.383, P < 0.001; r = 0.482, P = 0.037, respectively). Lateral E/E' and LVP(PRE-A) showed good correlation in groups A, B and C (r = 0.470, P < 0.001; r = 0.416, P = 0.028; r = 0.727, P < 0.001, respectively). The largest area under the receiver operating curve was obtained by the lateral E/E' for the prediction of a high LVFP, irrespective of the location of RWMA.
  
  
  CONCLUSIONS
  In selected patients with abnormal wall motion of the basal septum, E/E' measured at the septum was not representative for LVFP. Lateral E/E' is reliable for the prediction of high LVFP, regardless of the site of RWMA.
authors.affiliation: Ajou University Medical Center, Suwon, Korea.
authors.forename: Hong-Seok
authors.initials: HS
authors.lastname: Lim
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Sung-Gyun
authors.initials: SG
authors.lastname: Ahn
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Joon-Han
authors.initials: JH
authors.lastname: Shin
mesh_terms: D000704:Analysis of Variance; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012372:ROC Curve; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017725:Ventricular Pressure / Q000502:physiology*