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Re: [echocardiography] E/e' ratio

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  • Mark Harry
    I would have to agree with Richard. I will try to post some illustrative cases in the near future.
    Message 1 of 10 , Dec 21, 2004
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      I would have to agree with Richard. I will try to post some
      illustrative cases in the near future.


      On Dec 21, 2004, at 9:17 AM, Weiss, Richard wrote:

      > the real question is:
      >
      > Is it of any clinical value?
      > We tried the ratio in our lab for a number of months and had not found
      > it to be that useful in detecting high filling pressures compared with
      > our "standard assessments"
      >
      >
      >
      >
      > -----Original Message-----
      > From: Rogers, Brendan [mailto:rogersb@...]
      > Sent: Tuesday, December 21, 2004 3:42 AM
      > To: 'echocardiography@yahoogroups.com'
      > Subject: RE: [echocardiography] E/e' ratio
      >
      >
      >
      >
      > Start with:
      >
      > Longitudinal ventricular Function: Normal Values of Atrioventricular
      > Annular
      > and Myocardial Velocities Measured with Quantitative Two-dimensional
      > Colour
      > Doppler Tissue Imaging   (J Am Soc Echocardiogr 2003; 16:906-21
      >
      > and then check out:
      >
      > Hypertrophic Cardiomyopathy: From Bedside to Bench ... And Now Back
      > Again?
      >         Steve R. Ommen and A. Jamil Tajik
      >         Circulation 2001 104: 126 - 127
      >
      >
      >
      > > -----Original Message-----
      > > From: clotiii [SMTP:wct3wct@...]
      > > Sent: 20 December 2004 16:02
      > > To:   echocardiography@yahoogroups.com
      > > Subject:      [echocardiography] E/e' ratio
      > >
      > >
      > >
      > > I am having difficulty finding the normal value for the E/e' ratio. 
      > > Please post the values and where they were found, thank you.
      > >
      > >
      > >
      > >
      > >
      > > 
      > > Yahoo! Groups Links
      > >
      > >
      > >
      > > 
      > >
      > >
      >
      >
      >
      >  
      > Yahoo! Groups Links
      >
      >
      >
      >  
      >
      >
      >
      > Yahoo! Groups Links
      >
      > • To visit your group on the web, go to:
      > http://groups.yahoo.com/group/echocardiography/
      >  
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      > echocardiography-unsubscribe@yahoogroups.com
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      > Service.
      >
      >
    • echocanyons
      A recent JASE review (March 2004) titled A practical approach to the echocardiographic evaluation of Diastolic function. From S.J. Khouri and the Folks at
      Message 2 of 10 , Dec 21, 2004
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        A recent JASE review (March 2004) titled "A practical approach to the
        echocardiographic evaluation of Diastolic function." From S.J. Khouri and
        the Folks at Toledo, Ohio

        stated that >10 is abnormal(1) and 15 was highly specific for >LA
        pressures(2)

        But there is a question of its independence of loading

        figures referenced
        (1)Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler
        tissue imaginga noninvasive technique for evaluation of left ventricular
        relaxation and estimation of filling pressures. J Am Coll Cardiol
        1997;30:1527-33

        (2)Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et
        al. Clinical utility of Doppler echocardiography and tissue Doppler imaging
        in the estimation of left ventricular filling pressuresa comparative
        simultaneous Doppler-catheterization study. Circulation 2000;102:1788-94.
      • Elton Aguilar
        The latest issue of JASE has a new article on DTI for LV diastolic assessment. They cite a normal E/E ratio as 15. There is a grey
        Message 3 of 10 , Jan 28, 2005
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          Re: [echocardiography] E/e' ratio
          The latest issue of JASE has a new article on DTI for LV diastolic assessment. They cite a normal E/E' ratio as <8 and clear abnormal as >15. There is a grey zone between a ratio of 8 and 15 and they suggest using other echocardiographic indicators to help sort things out.

          Check out the article; it's a nice easy read:

          "Doppler Tissue Imaging for the Assessment of Left Ventricular Diastolic function: A Systematic Approach for the Sonographer"
          JASE January 2005, Volume 18 Number: 80-90

          Elton




          Elton Aguilar, BS RDCS
          President, Willamette Valley Society of Echocardiography
          http://home.comcast.net/~wvse/wvse/index.html

          608 NE 147th Circle
          Vancouver, WA  98685-5745
          360.910.0129 cell
          eltonaa@...

          On 12/20/04 8:02 AM, "clotiii" <wct3wct@...> wrote:

          >
          >
          > I am having difficulty finding the normal value for the E/e' ratio.  
          > Please post the values and where they were found, thank you.
          >
          >
          >
          >
          >
          >  
          > Yahoo! Groups Links
          >
          > <*> To visit your group on the web, go to:
          >     http://groups.yahoo.com/group/echocardiography/
          >
          > <*> To unsubscribe from this group, send an email to:
          >     echocardiography-unsubscribe@yahoogroups.com
          >
          > <*> Your use of Yahoo! Groups is subject to:
          >     http://docs.yahoo.com/info/terms/
          >  
          >
          >
          >
        • Sean Voss
          Question for all. POINT #1 When I do my DTI for E/E ratio which waves do we use when the E/A and E /A ratios change; for example I often find a patient whom
          Message 4 of 10 , Jan 30, 2005
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            Question for all.

            POINT #1 When I do my DTI for E/E' ratio which waves
            do we use when the E/A and E'/A' ratios change; for
            example I often find a patient whom has an E/A (mitral
            inflow) that is equal and maybe slightly reversed
            before valsalva but the waves will go from normal to
            reversed as patient breathes. I will have patient
            hold their breath and this often helps but sometimes
            not a cureall. Often I see patients that there waves
            change either height or ratio the longer they hold
            their breath. So which wave of mitral inflow do I
            take when it varies either with breathing or holding
            breath (and yes I double check, w/zoom on, my
            placement at leaflet tips).
            POINT/QUESTION #2 Often when I do the E'/A' DTI at
            mitral annulus I get reversal on the septal wall side
            and normal on the lateral side. They often don't
            agree with each other. In this case, which waveform
            do I use for my E/E' (also including the aforemention
            example). THanks all. Sean

            --- Elton Aguilar <eltonaa@...> wrote:

            >
            > The latest issue of JASE has a new article on DTI
            > for LV diastolic
            > assessment. They cite a normal E/E' ratio as <8 and
            > clear abnormal as >15.
            > There is a grey zone between a ratio of 8 and 15 and
            > they suggest using
            > other echocardiographic indicators to help sort
            > things out.
            >
            > Check out the article; it's a nice easy read:
            >
            > "Doppler Tissue Imaging for the Assessment of Left
            > Ventricular Diastolic
            > function: A Systematic Approach for the Sonographer"
            > JASE January 2005, Volume 18 Number: 80-90
            >
            > Elton
            >
            >
            >
            >
            > Elton Aguilar, BS RDCS
            > President, Willamette Valley Society of
            > Echocardiography
            > http://home.comcast.net/~wvse/wvse/index.html
            >
            > 608 NE 147th Circle
            > Vancouver, WA 98685-5745
            > 360.910.0129 cell
            > eltonaa@...
            >
            > On 12/20/04 8:02 AM, "clotiii"
            > <wct3wct@...> wrote:
            >
            > >
            > >
            > > I am having difficulty finding the normal value
            > for the E/e' ratio.
            > > Please post the values and where they were found,
            > thank you.
            > >
            > >
            > >
            > >
            > >
            > >
            > > Yahoo! Groups Links
            > >
            > >
            > >
            > >
            > >
            > >
            > >
            >
            >




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          • Victor Vasuvius
            There is so much talk about tissue Doppler. I do those recordings too, but you know what, my doctors do not use any of those numbers in pt management. My docs
            Message 5 of 10 , Feb 5, 2005
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              There is so much talk about tissue Doppler. I do those recordings too, but you know what, my doctors do not use any of those numbers in pt management. My docs are pretty good, uptodate with what is going on. Of course there are lots of calls about LV function and EF, even in the middle of the night. Rarely however I have come across when some one asks me, "I need the E/E' ratio or whatever.. I need that info to take care of my patient" Why is it? Either my docs are stupid, or the whole tissue Doppler business is overblownn. Would like some enlightenment from people who are both echo experts and also caring docs.
               
              Thank you.
               
              Vic V


              Sean Voss <ssv15760_2000@...> wrote:

              Question for all.

              POINT #1 When I do my DTI for E/E' ratio which waves
              do we use when the E/A and E'/A' ratios change; for
              example I often find a patient whom has an E/A (mitral
              inflow) that is equal and maybe slightly reversed
              before valsalva but the waves will go from normal to
              reversed as patient breathes. I will have patient
              hold their breath and this often helps but sometimes
              not a cureall. Often I see patients that there waves
              change either height or ratio the longer they hold
              their breath. So which wave of mitral inflow do I
              take when it varies either with breathing or holding
              breath (and yes I double check, w/zoom on, my
              placement at leaflet tips).
              POINT/QUESTION #2 Often when I do the E'/A' DTI at
              mitral annulus I get reversal on the septal wall side
              and normal on the lateral side. They often don't
              agree with each other. In this case, which waveform
              do I use for my E/E' (also including the aforemention
              example). THanks all. Sean

              --- Elton Aguilar wrote:

              >
              > The latest issue of JASE has a new article on DTI
              > for LV diastolic
              > assessment. They cite a normal E/E' ratio as <8 and
              > clear abnormal as >15.
              > There is a grey zone between a ratio of 8 and 15 and
              > they suggest using
              > other echocardiographic indicators to help sort
              > things out.
              >
              > Check out the article; it's a nice easy read:
              >
              > "Doppler Tissue Imaging for the Assessment of Left
              > Ventricular Diastolic
              > function: A Systematic Approach for the Sonographer"
              > JASE January 2005, Volume 18 Number: 80-90
              >
              > Elton
              >
              >
              >
              >
              > Elton Aguilar, BS RDCS
              > President, Willamette Valley Society of
              > Echocardiography
              > http://home.comcast.net/~wvse/wvse/index.html
              >
              > 608 NE 147th Circle
              > Vancouver, WA 98685-5745
              > 360.910.0129 cell
              > eltonaa@...
              >
              > On 12/20/04 8:02 AM, "clotiii"
              > wrote:
              >
              > >
              > >
              > > I am having difficulty finding the normal value
              > for the E/e' ratio.
              > > Please post the values and where they were found,
              > thank you.
              > >
              > >
              > >
              > >
              > >
              > >
              > > Yahoo! Groups Links
              > >
              > >
              > >
              > >
              > >
              > >
              > >
              >
              >




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