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Prognostic value of the E/e′ ratio among octogenarians in Singapore
  1. Punitha Arasaratnam1,
  2. Evelyn Lee2
  1. 1Department of Medicine, Jurong Health, Alexandra Hospital, Singapore, Singapore
  2. 2Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore
  1. Correspondence to Dr Punitha Arasaratnam, Department of Medicine, Jurong Health, Alexandra Hospital, Singapore 159964, Singapore; dr_punitha28{at}


Background This study sought to investigate the prognostic value of the medial E (early transmitral flow velocity) to e′ (early diastolic mitral annulus velocity) ratio (E/e′) using the standard cutoff value of 15 among octogenarians stratified according to left ventricular ejection fraction (LVEF), atrial fibrillation (AF) and diabetes.

Methods We examined a consecutive, single-centre cohort of 1197 subjects (male = 39.3%, female = 60.6%) between 80 and 89 years old (mean ± SD = 82.9 ± 2.81) who underwent transthoracic echocardiography from January 2009 to January 2011. E/e′ and LVEF were measured. These subjects were prospectively followed up for 29 months (mean ± SD = 12.8 ± 7.9). Primary endpoint was all-cause mortality.

Results In univariate analysis, patients with underlying AF (AF vs no AF, p<0.001), diabetes (diabetes vs no diabetes, p<0.001), cancer (cancer vs no cancer, p<0.001), LVEF <45% (≥45% vs <45%, p<0.001) or an E/e′ ≥15 (≥15 vs <15, p<0.001) had a poorer prognosis. Gender had no significant effect on prognosis (p<0.08). In multivariate analysis, age, AF, diabetes, cancer, a LVEF <45% and E/e′ ≥15 were significant, independent predictors of a poor prognosis.

Conclusions E/e′ is a predictor of mortality among octogenarians independently of LVEF, AF and diabetes.

  • Imaging and Diagnostics

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