A comparative Doppler-catheterization study of the left ventricular end diastolic pressure

Objectives To assess the correlation between the non-invasively measured ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/E’) and invasively measured left ventricular end diastolic pressure (LVEDP) in our context. Methods This is a prospective study of 66 patients (40 males and 26 females) who underwent elective coronary angiogram done at Inkosi Albert Luthuli Central Hospital. Transthoracic spectral Doppler and tissue Doppler echocardiography was performed to measure early diastolic transmitral flow velocities (E) and early diastolic medial and lateral mitral annular velocity (E’) respectively. LVEDP was directly measured during left ventriculography in a cardiac catheterization laboratory. Statistical analysis was done to compare E/E’ lateral and E/E’ medial to LVEDP in the study group and in different clinical subsets. Results Among 21 patients with E/E’ lateral and 27 patients with E/E’ medial of >8, 17 (81%) lateral group and 18 (67%) medial group had a LVEDP of >15mmHg, p value of 0.001 and 0.008 respectively. Raised E/E’ lateral ratio that is raised LVEDP was found in 90.9% of females, 52% in those with diabetes and 41.9% in those with hypertension which is statistically significant but not in smokers (30%) or those with dyslipidemia (31.3%) or a positive family history of premature coronary artery disease (20.5%). Conclusion This study confirmed that non-invasively measured E/E’ ratio correlates well with LVEDP in our study population.