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Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients Overall and Cause-Specific Mortality in Randomized Clinical Trials Comparing Percutaneous Interventions With Coronary Bypass Surgery: A Meta-analysis 2-Year Outcomes After Stenting of Lipid-Rich and Nonrich Coronary Plaques Advances in Coronary No-Reflow Phenomenon-a Contemporary Review Coronary Artery Calcium Is Associated with Left Ventricular Diastolic Function Independent of Myocardial Ischemia Effect of Aspirin on All-Cause Mortality in the Healthy Elderly Long-Term Outcomes of Biodegradable Versus Second-Generation Durable Polymer Drug-Eluting Stent Implantations for Myocardial Infarction Management of two major complications in the cardiac catheterisation laboratory: the no-reflow phenomenon and coronary perforations Genetic dysregulation of endothelin-1 is implicated in coronary microvascular dysfunction Radionuclide Image-Guided Repair of the Heart
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Review Article2017 Mar 21;69(11):1451-1464.

JOURNAL：J Am Coll Cardiol. Article Link

A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure

Mitter SS, Shah SJ, Thomas JD. Keywords: Doppler; LV relaxation; echocardiography; heart failure with preserved ejection fraction

ABSTRACT

Diastolic dysfunction represents a combination of impaired left ventricular (LV) relaxation, restoration forces, myocyte lengthening load, and atrial function, culminating in increased LV filling pressures. Current Doppler echocardiography guidelines recommend using early to late diastolic transmitral flow velocity (E/A) to assess diastolic function, and E to early diastolic mitral annular tissue velocity (E/e') to estimate LV filling pressures. Although both parameters have important diagnostic and prognostic implications, they should be interpreted in the context of a patient's age and the rest of the echocardiogram to describe diastolic function and guide patient management. This review discusses: 1) the physiological basis for the E/A and E/e' ratios; 2) their roles in diagnosing diastolic dysfunction; 3) prognostic implications of abnormalities in E/A and E/e'; 4) special scenarios of the E/A and E/e' ratios that are either useful or challenging when evaluating diastolic function clinically; and 5) their usefulness in guiding therapeutic decision making.

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