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Early-diastolic mitral annular velocity (e') and the ratio of early-diastolic left ventricular (LV) inflow velocity (E) to e' (E/e') have been widely used as indexes of LV relaxation and filling pressure, respectively. However, many recent studies have demonstrated that they are not reliable in various clinical settings. We thus investigated the factors influencing these echocardiographic parameters in a multicenter study.Methods and Results:The study group comprised 69 patients, referred for cardiac catheterization, and enrolled in 5 university hospitals. Time constant (τ) and LV mean diastolic pressure (LVMDP) were measured using a micromanometer-tipped catheter. Although e' only weakly correlated with τ (r=-0.35, P&lt;0.01), E/e' modestly correlated with LVMDP (r=0.48, P&lt;0.001). Multivariable analysis revealed that hypertension (β=-0.33, P&lt;0.01) and LV ejection fraction (LVEF) (β=0.44, P&lt;0.001) were the independent determinants of e', and LV mass index (LVMI) (β=0.37, P&lt;0.001) and LVMDP (β=0.47, P&lt;0.001) were those of E/e'. Additionally, E/e' significantly correlated with LVMDP in patients with normal LVMI (r=0.74, P&lt;0.001) but not in those with increased LVMI.

Left Ventricular Mass Influences Relationship Between Filling Pressure and Early-Diastolic Ratio of Inflow Velocity to Mitral Annular Velocity (E/e′)