Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study

Mats Christian Højbjerg Lassen; Kristoffer Grundtvig Skaarup; Niklas Dyrby Johansen; Flemming Javier Olsen; Atif N Qasim; Gorm Boje Jensen; Peter Schnohr; Rasmus Møgelvang; Tor Biering-Sørensen

doi:10.1016/j.echo.2023.06.012

Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study

Mats Christian Højbjerg Lassen^*, Kristoffer Grundtvig Skaarup, Niklas Dyrby Johansen, Flemming Javier Olsen, Atif N Qasim, Gorm Boje Jensen, Peter Schnohr, Rasmus Møgelvang, Tor Biering-Sørensen

^*Corresponding author for this work

3 Citations (Scopus)

Abstract

BACKGROUND: The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.

METHODS: Healthy participants from a prospective general population study, the Fifth Copenhagen City Heart Study, were assessed to establish reference values for E/e'sr derived from two-dimensional speckle-tracking echocardiography. The prevalence of abnormal E/e'sr was assessed in participants with cardiovascular risk factors or specific diseases.

RESULTS: The population comprised 1,623 healthy participants (median age, 45; interquartile range, 32-56; 61% female). The upper reference limit for E/e'sr in the population was 79.6 cm. Following multivariable adjustment, male participants exhibited significantly higher E/e'sr than female participants (upper reference limit for male participants, 83.7 cm; for female participants, 76.5 cm). For both sexes, E/e'sr increased in a curvilinear fashion with age such that the largest increases in E/e'sr were observed in participants >45 years. In the entire CCHS5 population with E/e'sr available (n = 3,902), increasing age, body mass index, systolic blood pressure, male sex, estimated glomerular filtration rate, and diabetes were associated with E/e'sr (all P < .05). Total cholesterol was associated with a less steep increase in E/e'sr. Abnormal E/e'sr was seldomly observed in participants with normal diastolic function but became more frequent in participants with increasing grades of diastolic dysfunction (normal, mild, moderate, severe [abnormal E/e'sr for each grade: 4.4% vs 20.0% vs 16.2% vs 55.6%, respectively]).

CONCLUSION: The E/e'sr differs between sexes and is age dependent such that E/e'sr increases with advancing age. Therefore, we established sex- and age-stratified reference values for E/e'sr.

Original language	English
Journal	Journal of the American Society of Echocardiography
Volume	36
Issue number	11
Pages (from-to)	1204-1212
Number of pages	9
ISSN	0894-7317
DOIs	https://doi.org/10.1016/j.echo.2023.06.012
Publication status	Published - Nov 2023

Keywords

Diastole
Echocardiography
Female
Humans
Male
Middle Aged
Prospective Studies
Reference Values
Ventricular Function, Left/physiology

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10.1016/j.echo.2023.06.012

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Lassen, M. C. H., Skaarup, K. G., Johansen, N. D., Olsen, F. J., Qasim, A. N., Jensen, G. B., Schnohr, P., Møgelvang, R., & Biering-Sørensen, T. (2023). Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study. Journal of the American Society of Echocardiography, 36(11), 1204-1212. https://doi.org/10.1016/j.echo.2023.06.012

Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study. / Lassen, Mats Christian Højbjerg; Skaarup, Kristoffer Grundtvig ; Johansen, Niklas Dyrby et al.
In: Journal of the American Society of Echocardiography, Vol. 36, No. 11, 11.2023, p. 1204-1212.

Research output: Contribution to journal › Journal article › Research › peer-review

Lassen, MCH, Skaarup, KG , Johansen, ND , Olsen, FJ, Qasim, AN, Jensen, GB, Schnohr, P , Møgelvang, R & Biering-Sørensen, T 2023, 'Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study', Journal of the American Society of Echocardiography, vol. 36, no. 11, pp. 1204-1212. https://doi.org/10.1016/j.echo.2023.06.012

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title = "Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study",

abstract = "BACKGROUND: The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.METHODS: Healthy participants from a prospective general population study, the Fifth Copenhagen City Heart Study, were assessed to establish reference values for E/e'sr derived from two-dimensional speckle-tracking echocardiography. The prevalence of abnormal E/e'sr was assessed in participants with cardiovascular risk factors or specific diseases.RESULTS: The population comprised 1,623 healthy participants (median age, 45; interquartile range, 32-56; 61% female). The upper reference limit for E/e'sr in the population was 79.6 cm. Following multivariable adjustment, male participants exhibited significantly higher E/e'sr than female participants (upper reference limit for male participants, 83.7 cm; for female participants, 76.5 cm). For both sexes, E/e'sr increased in a curvilinear fashion with age such that the largest increases in E/e'sr were observed in participants >45 years. In the entire CCHS5 population with E/e'sr available (n = 3,902), increasing age, body mass index, systolic blood pressure, male sex, estimated glomerular filtration rate, and diabetes were associated with E/e'sr (all P < .05). Total cholesterol was associated with a less steep increase in E/e'sr. Abnormal E/e'sr was seldomly observed in participants with normal diastolic function but became more frequent in participants with increasing grades of diastolic dysfunction (normal, mild, moderate, severe [abnormal E/e'sr for each grade: 4.4% vs 20.0% vs 16.2% vs 55.6%, respectively]).CONCLUSION: The E/e'sr differs between sexes and is age dependent such that E/e'sr increases with advancing age. Therefore, we established sex- and age-stratified reference values for E/e'sr.",

keywords = "Diastole, Echocardiography, Female, Humans, Male, Middle Aged, Prospective Studies, Reference Values, Ventricular Function, Left/physiology",

author = "Lassen, {Mats Christian H{\o}jbjerg} and Skaarup, {Kristoffer Grundtvig} and Johansen, {Niklas Dyrby} and Olsen, {Flemming Javier} and Qasim, {Atif N} and Jensen, {Gorm Boje} and Peter Schnohr and Rasmus M{\o}gelvang and Tor Biering-S{\o}rensen",

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year = "2023",

month = nov,

doi = "10.1016/j.echo.2023.06.012",

language = "English",

volume = "36",

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T1 - Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study

AU - Lassen, Mats Christian Højbjerg

AU - Skaarup, Kristoffer Grundtvig

AU - Johansen, Niklas Dyrby

AU - Olsen, Flemming Javier

AU - Qasim, Atif N

AU - Jensen, Gorm Boje

AU - Schnohr, Peter

AU - Møgelvang, Rasmus

AU - Biering-Sørensen, Tor

PY - 2023/11

Y1 - 2023/11

N2 - BACKGROUND: The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.METHODS: Healthy participants from a prospective general population study, the Fifth Copenhagen City Heart Study, were assessed to establish reference values for E/e'sr derived from two-dimensional speckle-tracking echocardiography. The prevalence of abnormal E/e'sr was assessed in participants with cardiovascular risk factors or specific diseases.RESULTS: The population comprised 1,623 healthy participants (median age, 45; interquartile range, 32-56; 61% female). The upper reference limit for E/e'sr in the population was 79.6 cm. Following multivariable adjustment, male participants exhibited significantly higher E/e'sr than female participants (upper reference limit for male participants, 83.7 cm; for female participants, 76.5 cm). For both sexes, E/e'sr increased in a curvilinear fashion with age such that the largest increases in E/e'sr were observed in participants >45 years. In the entire CCHS5 population with E/e'sr available (n = 3,902), increasing age, body mass index, systolic blood pressure, male sex, estimated glomerular filtration rate, and diabetes were associated with E/e'sr (all P < .05). Total cholesterol was associated with a less steep increase in E/e'sr. Abnormal E/e'sr was seldomly observed in participants with normal diastolic function but became more frequent in participants with increasing grades of diastolic dysfunction (normal, mild, moderate, severe [abnormal E/e'sr for each grade: 4.4% vs 20.0% vs 16.2% vs 55.6%, respectively]).CONCLUSION: The E/e'sr differs between sexes and is age dependent such that E/e'sr increases with advancing age. Therefore, we established sex- and age-stratified reference values for E/e'sr.

AB - BACKGROUND: The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.METHODS: Healthy participants from a prospective general population study, the Fifth Copenhagen City Heart Study, were assessed to establish reference values for E/e'sr derived from two-dimensional speckle-tracking echocardiography. The prevalence of abnormal E/e'sr was assessed in participants with cardiovascular risk factors or specific diseases.RESULTS: The population comprised 1,623 healthy participants (median age, 45; interquartile range, 32-56; 61% female). The upper reference limit for E/e'sr in the population was 79.6 cm. Following multivariable adjustment, male participants exhibited significantly higher E/e'sr than female participants (upper reference limit for male participants, 83.7 cm; for female participants, 76.5 cm). For both sexes, E/e'sr increased in a curvilinear fashion with age such that the largest increases in E/e'sr were observed in participants >45 years. In the entire CCHS5 population with E/e'sr available (n = 3,902), increasing age, body mass index, systolic blood pressure, male sex, estimated glomerular filtration rate, and diabetes were associated with E/e'sr (all P < .05). Total cholesterol was associated with a less steep increase in E/e'sr. Abnormal E/e'sr was seldomly observed in participants with normal diastolic function but became more frequent in participants with increasing grades of diastolic dysfunction (normal, mild, moderate, severe [abnormal E/e'sr for each grade: 4.4% vs 20.0% vs 16.2% vs 55.6%, respectively]).CONCLUSION: The E/e'sr differs between sexes and is age dependent such that E/e'sr increases with advancing age. Therefore, we established sex- and age-stratified reference values for E/e'sr.

KW - Diastole

KW - Echocardiography

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Reference Values

KW - Ventricular Function, Left/physiology

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JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

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ER -

Normal Values and Reference Ranges for the Ratio of Transmitral Early Filling Velocity to Early Diastolic Strain Rate - The Copenhagen City Heart Study

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