E/a´ ratio a simple detector of left ventricular dysfunction in patients with decreased ejection fraction.

OBJECTIVES: Could a diastolic dysfunction and an increased LV-filling pressure according to ASE/EACVI guidelines be detected or ruled out by the E/a´ratio in patients with decreased ejection fraction.

DESIGN: We retrospectively evaluated the diastolic function of 113 unselected in-hospital patients, aged 40-84 years, in sinus rhythm and with no or mild valve disease, having a decreased systolic function (EF ≤50%) using the new ASE/EACVI guidelines and compared these results with the E/a´ratio derived from the E wave in the mitral flow and the a´velocity in the tissue Doppler.

RESULTS: The average E/a´ ratio is a strong predictor of a grade II-III diastolic dysfunction and an elevated left atrial pressure according to ASE/EACVI guidelines with an AUC of 0.92. An average E/a´ ratio with a cut-off >10 had a sensitivity of 97.6% and a negative predictive value of 98.2% in detecting or ruling out a grade II-III diastolic dysfunction and an elevated left atrial pressure according to the current guidelines.

CONCLUSION: The average E/a´ ratio might be useful as a fast screening tool of a left ventricular dysfunction and an increased left ventricular filling pressure in patients with a decreased ejection fraction.