Abstract 14980: The Relationship Between Transmitral Doppler Early Filling Velocity to Tissue Doppler Early Diastolic Mitral Annular Velocity Ratio and Mortality is Dependent Upon Age and Gender
Background: Recent data suggest that the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/E') may predict cardiac events in selected populations. However, the impact of age and gender on E/E', when used as a prognostic indicator, has not been fully evaluated.
Hypothesis: We hypothesized that E/E' may be a useful predictor of total mortality in the absence of LV systolic dysfunction (LVSD) in a large community based cohort and analysed the impact of age and gender on the prognostic value of E/E'.
Methods: The study cohort comprised of all patients who had a routine echocardiography in Ninewells Hospital between 2007 and 2009. Patients with impaired LV systolic function were excluded. The echocardiographic data were then linked to the national mortality database of Scotland by a unique patient identifier. Cox regression analysis was used to assess differences in all-cause mortality between those who had a raised E/E' ratio compared to those who had a normal E/E' ratio.
Results: A total of 2126 patients (Mean age 61.8±16.8, 52% Female) were included in the study. Mean E/E' was higher in females than males (p<0.0001). Linear regression model revealed age and gender as highly significant predictors of E/E' (R2=0.21, p<0.0001). Using cut off values of =8, =10 and =15, 930 (43.7%), 558 (26.2%) and 137 (6.4%) patients had a raised E/E' ratio, respectively. After a mean follow up of 350±160 days, 70 (3.3%) patients died. Although a raised E/E' ratio seems to predict mortality at all three cut off values used (HR 1.4, 1.3 and 1.4 respectively, P<0.05), this predictive ability largely disappeared when corrected for age and gender.
Conclusion: Age and gender are important determinants of E/E' ratio in the absence of LV systolic dysfunction. E/E' ratio predicts mortality in a large community based cohort but not independent of age or gender. While interpreting the value of E/E' in patients without systolic dysfunction, age and gender specific cut off may be required.
- © 2010 by American Heart Association, Inc.