Assessment of the American Society of Echocardiography-European Association of Echocardiography guidelines for diastolic function in patients with depressed ejection fraction: an echocardiographic and invasive haemodynamic study

Aims There is controversy surrounding the accuracy of echo-Doppler variables, including early mitral inflow/mitral annular velocity ( E / e ′), for estimating left ventricular filling pressure (LVFP) in patients with depressed ejection fraction (EF < 50%). Methods and results The American Society of Echocardiography-European Association of Echocardiography (ASE-EAE) algorithm for diastolic function in depressed LVEF was retrospectively applied to a database of patients who underwent echocardiography ≤20 min of cardiac catheterization. LV pre-atrial contraction pressure (pre-A) ≥15 mmHg was elevated. Of 62 patients studied, the mean age was 53.6 ± 10.6 years and the mean LVEF was 27.2 ± 11.8%. The correlations of E / e ′ ( R = 0.43, P = 0.0005) and E ( R = 0.39, P = 0.002) with LV pre-A were modest, compared with pulmonary artery pressure (PAP, R = 0.69, P = 0.0006), E /late mitral ( A ) velocity ( R = 0.52, P 15 or 2 and DT 50 cm/s were correctly classified using the addition of E / e ′ and PAP. Conclusion This retrospective study shows that in this population with depressed LVEF, no single echo-Doppler variable had high accuracy for predicting LV pre-A ≥15 mmHg. However, the ASE-EAE algorithm using multiple variables predicted LVFP with good accuracy, superior to any single echo-Doppler variable alone.