Cardiac ECHO measurements

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Q:

We have some Cardiologists who dictate E:A ratio and some who also in the same report say E:A and later E:a, or E/A and E/a.  I’ve searched but don’t find anything conclusive as to why anything else would be correct other than E:A or E/A.  Could I get some feedback please?  Thank you.

A:

You must work in an ECHO lab! The E/A ratio is a cardiac ECHO measurement for the presence of “diastolic heart failure (DHF)”:

Normal diastolic function. Doppler recordings of normal transmitral filling velocities. An E/A wave ratio between 0.75 and 1.5 and deceleration time (DT) greater than 140 milliseconds is characteristic of a normal filling pattern.

You can read more here:
http://www.cardiac-risk-assessment.com/ca-blog/heart-function-failure/
http://www.cardiac-risk-assessment.com/ca-blog/how-serious-is-mild-septal-hypertrophy-noted-and-mild-lv-diastolic-dysfunction-on-my-cardiac-echo/
The diagnosis of DHF is generally based on the finding of typical symptoms and signs of Heart Failure (HF) in a patient who is shown to have a normal left ventricular ejection fraction and no valvular abnormalities on ECHO. Measurement of diastolic function is complex and dependent on loading conditions of the heart. Multiple parameters may be measured. Two such parameters are transmitral velocity and deceleration time: Blood flow across the mitral valve occurs in 2 phases: an early transmitral flow (E wave) and a late flow with atrial contraction (A wave). The relative contribution of each is expressed as a ratio (E/A). An E/A ratio less than 0.75 or greater than 1.5 indicates DD.
Hope this helps,
Dr T
http://www.cardiac-risk-assessment.com/

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