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Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction

Prognostic and clinical implications

Jacob E. Møller, MD^*, Eva Søndergaard, MD^*, James B. Seward, MD, FACC, Christopher P. Appleton, MD, FACC and Kenneth Egstrup, MD, DMSci, FESC^*

^* Department of Medicine, Svendborg Hospital, Svendborg, Denmark
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA

View larger version (147K): [in a new window]   Figure 1 Flow propagation velocity (Vp) was determined as the slope (yellow line) of the isovelocity line from the mitral plane to 4 cm apically into the left ventricle. Top left: Color M-mode recording of LV inflow from a normal subject. Bottom left: Pulsed wave Doppler signal of normal transmitral flow. E/Vp in this control was 0.99. Top right: Color M-mode recording from a patient with anterior MI and decreased Vp but normal appearing pulsed wave Doppler signal of LV mitral inflow (Bottom right). E/Vp in this patient was 2.1. E: peak E-wave velocity.

View larger version (37K): [in a new window]   Figure 2 Highest Killip class in patients classified after the ratio of peak E-wave velocity and flow propagation velocity 1.5. Killip class in the group with E/Vp 1.5 was significantly higher than the group with normal ratio (p < 0.0001 Mann-Whitney U rank test).

View larger version (21K): [in a new window]   Figure 3 Effect of diastolic function on cardiac survival. Top: Kaplan Meier curves in patients grouped after the ratio of peak E wave velocity and flow propagation velocity (E/Vp). Bottom: Kaplan Meier curves in patients grouped after E-wave deceleration time (Dt).