E/e’ as a Predictor of Short-Term Survival Following ST-Elevation Myocardial Infarction

Background: We examined the usefulness of tissue Doppler imaging in evaluating the diastolic dysfunction and assessed the prognostic value of ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) in unselected patients with acute ST-elevation myocardial infarction (STEMI). Methods: Patients presenting with acute STEMI at Osmania General Hospital, Hyderabad, India between January-2012 and June-2012 were examined in this study. All patients underwent echocardiographic examination comprising Doppler assessment of transmitral flow velocities (peak E-wave velocity) and Doppler tissue imaging of the medial mitral valve annulus (e’). All patients were followed up for 6 months and all-cause mortality was measured as the study endpoint. Role of E/e’ ratio as a predictor of survival after acute STEMI was evaluated by a comparative analysis of patients with E/e’ ≤15 and >15. Results: A total of 50 patients with acute STEMI (mean age: 52.2 ± 13.2 years; 80% males) were analyzed in this study. Of them, 23 (46%) patients had an E/e’ >15. Clinical parameters such as Killip class ≥2 as well as left ventricular ejection fraction of <40% were significantly associated with E/e’ >15. Five (10%) patients died during the 6-month follow-up period. All deaths occurred among patients from the E/e’ >15 group, indicating that E/e’ is an effective predictor of overall survival. Conclusion: E/e’ ratio was identified as a strong predictor of survival after acute myocardial infarction and can be suitable for risk-stratification of patients in this setting. Further studies are warranted to substantiate the findings.