Pharm student needs help: E/e' ratio

[bp2313]

Hello everyone,

I'm a pharmacy student and I'm doing a journal club on spironolactone in HF with preserved EF. I just realized (a little too late) that this article is too technical for me but I'll go (down probably) with it anyway. Can anyone give me a simple interpretation of the E/e' ratio (used as one of the primary endpoints) please?

I really appreciate it. Thanks.

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[dragonfly99]

An elevated E:e' ratio is one of the echo parameters used to evaluate for diastolic dysfunction. The more elevated this ratio, the more it suggests there is impaired relaxation of the left ventricle.
The e' is the velocity of the mitral annulus. If the heart is stiff, the motion will be less and that makes the radio more elevated (if e' is lower/smaller).
It depends which textbook you look in - most say that >12 is the cutoff for abnormal, some say <8 is normal, 8-12 intermediate, >12 is abnormal. Definitely >15 implies diastolic dysfunction.

This is just *one* parameter used to measure diastolic dysfunction. the problem is that diastolic dysfunction is hard to quantify/measure, and these numbers like E:e' can probably change to some degree with small changes in patients' volume status and meds, etc. And also there is the skill of the echocardiographer doing the measuring and how "good" or bad echo windows are for the patient - some patients are just obese, have COPD with hyperexpanded lungs, etc. It affects our ability to get good echo images.