title: Left atrial distensibility and E/e' for estimating left ventricular filling pressure in patients with stable angina. -A comparative echocardiography and catheterization study-.
abstract: BACKGROUND
  Although E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) is widely used to measure left ventricular filling pressure (LVFP), its accuracy is questionable in coronary artery disease patients.
  
  
  RESULTS
  Echocardiograms and LVFP were obtained from 174 patients with stable angina (Canadian Cardiovascular Society angina grade I-II) who had received interventions for angiography-confirmed coronary stenosis. Compared with single-vessel groups, the multiple-vessel group exhibited lower mitral annular velocities, higher LVFP, and stronger correlations between E/regional e' and LVFP. Additionally, stronger correlations between E/regional e' and LVFP existed in patients with systolic dysfunction or lower variation of myocardial performance index (MPI) among anterior, inferior and lateral borders of mitral annulus. Average e' was not superior to any regional e' for assessing LVFP by the E/e' method. E/e' and left atrial (LA) ejection fraction (EF) correlated linearly with LVFP, but the correlation between LA distensibility and LVFP was logarithmical. Compared with E/e', LA distensibility and LAEF were superior for identifying high LVFP.
  
  
  CONCLUSIONS
  E/e' is not completely satisfactory for assessing LVFP in patients with stable angina, especially those with single-vessel disease, preserved systolic function or high MPI variation. For identifying high LVFP, LA distensibility and LAEF are better than E/e'.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan. a841120@ms3.hinet.net
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Hsiao
authors.forename: Kuan-Rau
authors.initials: KR
authors.lastname: Chiou
authors.forename: Ko-Long
authors.initials: KL
authors.lastname: Lin
authors.forename: Shih-Kai
authors.initials: SK
authors.lastname: Lin
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Huang
authors.forename: Feng-You
authors.initials: FY
authors.lastname: Kuo
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Cheng
authors.forename: Chun-Peng
authors.initials: CP
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D002302:Cardiac Output; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged