title: E/e' ratio is a strong prognostic predictor of mortality in patients with non-valvular atrial fibrillation with preserved left ventricular systolic function.
abstract: BACKGROUND
  The purpose of this study was to investigate the prognostic values of the E/e' ratio and other echocardiographic and clinical parameters in patients with non-valvular atrial fibrillation (AF) with preserved left ventricular (LV) systolic function.
  
  
  RESULTS
  A total of 488 patients (322 men, age: 66 ± 11 years) with non-valvular AF with preserved LV systolic function (LV ejection fraction >50%) were included. The E and e' velocities were measured in 5 consecutive heart beats and averaged. Mean follow-up duration after enrollment was 17.7 ± 5.3 months. All-cause deaths occurred in 45 patients (cardiovascular deaths: n=29). There were significant differences in age (65.6 ± 11.3 vs. 71.5 ± 9.1, P < 0.001) and hemoglobin concentration (13.6 ± 2.9 vs. 11.5 ± 3.4g/dl, P<0.0001) between the deceased group and the survivors. E/e' ratio in the deceased group was significantly higher than that in the survivors (17.67 ± 3.39 vs. 10.8 ± 3.30, P < 0.001). Survival analysis showed that a high E/e' ratio (> 15.0) represents a poorer prognosis (P < 0.001 by Log-Rank test) than an E/e' ratio of 15 and below. Multivariate analysis identified 2 significant variables that were predictive of all-cause deaths: hemoglobin (hazard ratio (HR)=0.806, 95% confidence interval (CI) = 0.733-0.886, P < 0.0001), and E/e' > 15 (HR=3.064, 95%CI = 1.38-6.804, P = 0.006).
  
  
  CONCLUSIONS
  E/e' ratio is a useful independent prognostic parameter for predicting mortality in patients with AF with preserved LV systolic function.
authors.affiliation: Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. sc.lea@samsung.com
authors.forename: Sung-Ji
authors.initials: SJ
authors.lastname: Park
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Shin Yi
authors.initials: SY
authors.lastname: Jang
authors.forename: Sung-A
authors.initials: SA
authors.lastname: Chang
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Choi
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D013599:Systole / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D006454:Hemoglobins