title: E/E' ratio is more sensitive than E/A ratio for detection of left ventricular diastolic dysfunction in patients with systemic sclerosis.
abstract: OBJECTIVE
  To investigate the efficiency of early filling (E) and early diastolic mitral annular velocity (E') ratio (E/E' ratio) assessed by tissue Doppler imaging (TDI) on early detection of diastolic left ventricular (LV) dysfunction in systemic sclerosis (SSc) patients without congestive heart failure (CHF) symptoms.
  
  
  METHODS
  Thirty-five Korean SSc patients without CHF symptoms and 35 healthy, age-sex matched controls were studied. Two-dimensional and M-mode echocardiography including conventional and tissue Doppler imaging was performed and pulmonary function test with diffusing capacity of lung for carbon monoxide was assessed.
  
  
  RESULTS
  Mean E and late filling (A) ratio (E/A ratio) showed no significant difference between the two groups, while TDI showed that SSc patients had significantly elevated E/E' ratio (10.6+/-4.2 vs. 8.8+/-2.2, p=0.032), in comparison with controls. SSc patients who had taken angiotensin converting enzyme inhibitor or angiotensin II receptor blocker had significantly lower E/E' than those who had not (8.0+/-2.4 vs. 11.9+/-4.3, p=0.01).
  
  
  CONCLUSIONS
  E/E' ratio is more sensitive than E/A ratio for identifying LV diastolic dysfunction in SSc patients without CHF symptoms. Furthermore, SSc patients who had received ACEI or ARB treatment showed significantly better preservation of LV diastolic function than those who had not received these medications.
authors.affiliation: Division of Rheumatology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: S Y
authors.initials: SY
authors.lastname: Jung
authors.forename: S T
authors.initials: ST
authors.lastname: Choi
authors.forename: Soo-Kon
authors.initials: SK
authors.lastname: Lee
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Park
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002248:Carbon Monoxide; D002302:Cardiac Output / Q000502:physiology*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002248:Carbon Monoxide