E/Em ratio for assessment of diastolic heart failure in patients with atrial fibrillation

Objective: To observe the diagnostic value of the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/Em) for diastolic heart failure (DHF) in patients with atrial fibrillation. Methods: Patients with nonvalvular atrial fibrillation and normal left ventricular ejection fraction (LVEF) were enrolled in the study, which were classified into DHF group (n=62) and non-heart failure group (NHF group, n=36). The clinical and echocardiographic data were compared between the two groups. ROC curve was used to assess the value of E/Em for the identification of DHF. Results: Compared with NHF group, patients with DHF were older, more had hypertension, higher NT-proBNP, larger left atrial, higher E, lower Em and higher E/Em (P<0.001). Using E/Em for identification of DHF, the area under ROC curve was 0.770 (95%CI: 0.675-0.865). Taking E/Em ≥9.50 as optimal cut-off value, the sensitivity, specificity, positive predictive value and negative predictive value was 67.7%, 72.2%, 71.0% and 69.1%, respectively. Conclusion: E/Em could be useful in identifying DHF in patients with atrial fibrillation.