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Erschienen in:
18.03.2020 | Review Article
The clinical application of the ratio of transmitral early filling velocity to early diastolic strain rate: a systematic review and meta-analysis
Erschienen in: Journal of Echocardiography | Ausgabe 2/2020
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Background
The ratio of transmitral early filling velocity to early diastolic strain rate (E/eʹsr) has recently emerged as a novel and accurate non-invasive measure of left ventricular (LV) filling pressure. This systematic review and meta-analysis aimed to give an overview of the possible clinical implications of E/eʹsr.
Methods
We conducted a systematic review and meta-analysis of all studies involving E/eʹsr. Of 598 identified studies, 16 met our inclusion criteria. Studies involving E/eʹsr either investigated its prognostic value (n = 9) or its correlation with invasively measured LV filling pressure (n = 7).
Results
The pooled meta-analysis showed a significant correlation between E/eʹsr and pulmonary capillary wedge pressure (PCWP) measured invasively across the studies assessing this relationship (Cohen’s d = 3.90 95% CI [2.38–6.39], p < 0.001) and between E/eʹsr and left ventricle end-diastolic pressure (LVEDP) measured invasively across the studies assessing this relationship (Cohen’s d = 5.30 95% CI [2.83–9.96], p < 0.001). The pooled analysis of the prognostic studies showed that E/eʹsr was a significant predictor of adverse outcomes after multivariable adjustment across the different study populations in a random effects model (overall estimated HR: 1.58 95% CI [1.28–1.96], p < 0.001, per 1 m increase).
Conclusion
E/eʹsr correlates well with invasive measures of LV filling pressure. In addition, E/eʹsr provides significant prognostic information across various patient populations. Further studies are needed to test if E/eʹsr has an advantage to E/eʹ.