Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction: Prognostic and clinical implications

Jacob E. Møller, Eva Søndergaard, James B. Seward, Christopher P. Appleton, Kenneth Egstrup

Research output: Contribution to journalArticlepeer-review

126 Scopus citations

Abstract

OBJECTIVES: To determine the ability of the ratio of peak E-wave velocity to flow propagation velocity (E/Vp) measured with color M-mode Doppler echocardiography to predict in-hospital heart failure and cardiac mortality in an unselected consecutive population with first myocardial infarction (MI). BACKGROUND: Several experimental studies indicate color M- mode echocardiography to be a valuable tool in the evaluation of diastolic function, but data regarding the clinical value are lacking. METHODS: Echocardiography was performed within 24 h of arrival at the coronary care unit in 110 consecutive patients with first MI. Highest Killip class was determined during hospitalization. Patients were divided into groups according to E/Vp <1.5 and ≥1.5. RESULTS: During hospitalization 53 patients were in Killip class ≥II. In patients with E/Vp ≥1.5, Killip class was significantly higher compared with patients with E/Vp <1.5 (p < 0.0001). Multivariate logistic regression analysis identified E/Vp ≥1.5 to be the single best predictor of in-hospital clinical heart failure when compared with age, heart rate, E-wave deceleration time (Dt), left ventricular (LV) ejection fraction, wall motion index, enzymatic infarct size and Q-wave MI. At day 35 survival in patients with E/Vp <1.5 was 98%, while for patients with E/Vp ≥1.5, it was 58% (p < 0.0001). Cox proportional hazards model identified Dt <140 ms, E/Vp ≥1.5 and age to be independent predictors of cardiac death, with Dt < 140 ms being superior to age and E/Vp. CONCLUSIONS: In the acute phase of MI, E/Vp ≥1.5 measured with color M-mode echocardiography is a strong predictor of in-hospital heart failure. Furthermore, E/Vp is superior to systolic measurements in predicting 35 day survival although Dt <140 ms is the most powerful predictor of cardiac death. (C) 2000 by the American College of Cardiology.

Original languageEnglish (US)
Pages (from-to)363-370
Number of pages8
JournalJournal of the American College of Cardiology
Volume35
Issue number2
DOIs
StatePublished - 2000

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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