E/E' ratio is more sensitive than E/A ratio for detection of left ventricular diastolic dysfunction in systemic lupus erythematosus

To investigate whether the ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') (E/E' ratio) can detect left ventricular diastolic dysfunction more sensitively than the ratio of E to mitral peak velocity of late filling (A) (E/A ratio) in systemic lupus erythematosus (SLE). A total of 137 patients with SLE were investigated and compared with 110 age-matched and sex-matched controls retrospectively. Two-dimensional echocardiography and M-mode echocardiography including conventional and tissue Doppler imaging were performed. There were no differences in the left ventricle ejection fractions and the mean E/A ratio between the two groups. However, the mean E/E' ratio of patients was higher than that of the controls (10.4 ± 4.0 vs 7.7 ± 2.1, P < 0.01). Significantly higher left ventricle ejection fractions and lower E/E' ratio were found in patients with systemic lupus erythematosus receiving angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker than those not receiving (P < 0.05). Our study showed that the E/E' ratio is more sensitive than the E/A ratio for detection of the left ventricle diastolic dysfunction. Furthermore, patients who had received angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment showed significantly better preservation of both systolic and diastolic function of left ventricle in comparison with those who had not received.